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Home My WebLink About2096DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36.56 -1 -16 BOX 18 �,. . . L , L �T 02096 SHkRLITA AMLER, MD, MS, FAAP Commissioner of Health ._,_ �.ORETTA MOI✓INA:I�N,�;;R�.SN: -..: �,�.;..,,._ ,.,,,...�,._�. Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT I BONDI County Executive Director of Environmental Health r ADDITION APPLICATION RESIDENTIAL ONLY STREET TOWN T TAX MAP# -A NAME PHONE PCHD# Iq -05`7708�_ MAILING ADDRESS �O DESCRIPTION OF ADDITION ZZI 00"x NUMBER OF EXISTING BEDROOMS 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., 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 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) 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 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 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 SUBJECT RESIDENTIAL SITE INQUIRY DATE : 04/21/2008 372400 PATTERSON 36.56 -1 -16 ROLL SEC TAXABLE PARCEL PRCLS 210 1 FAMILY RES OUNNER MITCHELL TOTAL RES SITES 1 LAND $50,800 50 JASPER RD TOTAL COM SITES 0 TOTAL $223,700 RES SITE R01 == = = = = == RESIDENCE I BLDG. STYLE COTTAGE.' - '''YEAR"-BUILT 1954 EXTWALL MAT WOOD STORIES 1.0 GRADE ECONOMY - - -AREAS - - PROPERTY CLASS 1 FAMILY RES I HEAT TYPE HOT AIR 1ST STORY: 900 ZONING R40 ( NO. OF FIREPLACES 2ND STORY: SEWER PRIVATE i N OF BATHROOMS 1.0 1/2 STORY: WATER PRIVATE NO. OF 'BEDROOMS 3/4 STORY: UTILITIES ELECTRIC 1 FIN BASMT: NEIGHBORHOOD 36200 I BAS. GAR. CAPACITY 2 TOTAL SFLA: 900 == =TOTAL IMPROVEMENT ITEMS 0 ==== 1==== =____= TOTAL LAND ITEMS 1 TYPE SIZE1 SIZE2 QUANI TYPE FRNT DPTH ACRES SQR FT 1 1 PRIME SITE I .97 F1 =MORE ITEMS I F6 =ASMNT INQUIRY F10 =G0 TO MENU 75.20 03 -050 F4 =NEXT RES SITE ON FILE F9 =G0 TO XREF Fll =PREV ITEMS 1 "Idr' GO U U a L GJd I UWII Ur rn 1 I cmaU O'tJ - O /O -LU 10 ('. L DAVID I. RAINES Code Enforcement Officer Fire Inspector Mission Arts Design Croup, Inc. 2 Ravmond Drive Carmel, New York 1 0512 RE: TM.- 36.56 -1 -16 WUNNER, MITCHELL 50 Jasper Road Brewster, New York (T /Patterson) TO WHOM IT MAY CONCF,RN: TOWN OF PATTERSON CODE ENFORCEMENT OFFICE - .PUTNA.M'COt7=.—'-..�:. P.O. Box 470 Patterson, New York 12563 March 26, 2008 TEI. (845) 878 - 6319 FAX (845) 878 - 2019 According to our records 'he 2 bedroom, si jgle- family dwelling on the above numbered lot was evidently constructed prior to ou oning Ordin e requiring a Certificate of Occupancy. The Building Department does not have a file or record of construction or violation fort-his dwelling. All dwellings for resale MUST have heat and smoke detectors in each bedroom and hallways prior to closing and also a CO2 detector on the lowest floor level that has bedrooms. The inforrnalion regarelinLT this dwelling was obloined fi•onz: Building Department XXX Assessor's records -__ XXX , Health Department Compliance`__ ^_ If you have any questions, please do not hesitate to contact this office. Very truly yours, C leryI `L. Sf+ ith, Building Department I'OWN ROAD XXX STATIC ROAD COUNTY ROAD PRIVATE: ROAD N issionArts Design Group, Inc. LETTER OF TRANSMITTAL 2 Ra and Drive. Date: March 27, 2008 • Phone: 84S-228-2333 RE: 845-228-2S94 e-mail: JmSinisi@MissionArtsDG.com TO: Putnam County Deft. of Health 1 Geneva Road Brewster, NY 10509 We are sending you ❑ U.S. Mail ❑ Originals ❑ Prints Wunner Residence — 50 Jasper Road Town of Patterson Tax Map No. 36.56 -1 -16 Project #: 3225 attached under separate cover, the following items via ❑ Overnight ❑ Pick Up ❑ Hand Delivery ❑ Reports ❑ Plans ❑ Colored Prints ❑ Photographic Exhibit ❑ Specifications ❑ Other: Copies Date Dwg. No. Description 1 3 -26 -08 Bedroom Count Letter from Town of Patterson 1 Health Dept. Addition Application 2 3 -27 -08 Proposed First Floor Plan 2 3 -27 -08 Proposed Second Floor Plan 2 3 -27 -08 Proposed Basement Floor Plan 2 3 -27 =08 Existing First Floor Plan 2 3 -27 -08 Existing Basement Floor Plan 2 ..._- 3 -27 -08 _._ S -1 Proposed Plot Plan 1 -10 -20 -03 Copy of Original Survey — Created by Robert BergendoriT These are transmitted: • For approval • Approved as noted ❑ For review /comment Remarks: ❑ Approved as submitted ❑ For your use • As requested ❑ Returned for corrections • Resubmit copies for approval ❑ Submit , copies for distribution SIGNED: L Jason K. Mitchell Copies to: Mitchell Wunner Joseph M. Sinisi, President, MissionArts Design Group Inc. File APR -23 -2008 11:54 Fcw MISSIONARTS DESIGN GROUP L "r`. 1 5 s l C IY - 8452282594 P.01/03 inc. "Architecture on a Finer Scale" To: Gene heed I'roITL' Cason K. Mitchell Fax: 278-7921 Pages. 3 Pbone: 778 -6130 at. 2261 pate: 4.23.08 Ike: Wminer Residence TM # 36.5b -1 -16 CC: Nile ❑ Urgent 0 For Review ❑ please Comment ❑ Pleasc Reply ❑ Please Recycle Attached please the existing conditions floor plans for Mitchell Wtmner's u f-; deuce Iocateci at 50 Jasper Road, Town of Patterson, as per our your recpest. Thanks. ■ QRay,rgrrll. HwCa nel, ny 105,19 ■ p6m, 845.29,8.9.333 ■ Fax- 845.9,28.£594 ■ X SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health May 1, 2008 Mission Arts Design 2 Raymond Drive Carmel, NY 10512 To Whom It May Concern: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Addition- A- 057 -08 No Increase in Number of Bedrooms 50 Jasper Road (T) Patterson, T.M. # 36.56 -1 -16 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 May 1, 2008. The addition is approved with the following conditions- 1. The total number of bedrooms must remain at two without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area must be maintained. -� _ -3. ': A41 plumbing-plumbing-xtures must be updated with water savink: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 (845) 278 -6130, ext. 2261. Sincerely, Gene D. Reed Senior Engineering Aide GDR:kly cc: BI, (T) Patterson Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5.186 Fax (845) 225 -5418 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 AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN �4 Associate Commissioner of Health Mission Arts Design Group 2 Raymond Drive Carmel, NY 10512 Attn: Jason Mitchell Dear Mr. Mitchell: ROBERT J. BONDI County Executive T ROBERT MORRIS, PPE 48YU Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 April 28, 2008 Re: Addition — A- 057 -08 50 Jasper Road (T) Patterson TM # 36.56 -1 -16 I have received and reviewed the plans for the proposed addition to the above mentioned residence. Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: 1. The legal bedroom count for the dwelling is two. The potential bedroom count of your proposed addition is three. The Family Room is considered a potential bedroom along with the two proposed bedrooms. --=- - - ° • - -• - - = -• �2: - ?die -- addition -o€ a potential bedroom req��ires th? s: Department's apps. oval of a nevi sed . _ .. .... , septic system plan from a professional engineer Please review the proposed floor plan to reflect no more than two potential bedrooms, or have a professional engineer or registered architect design a sub - surface sewage treatment system meeting present code requirements for three bedrooms. GDR:kly Sincerely, Gene D. Reed Sr. Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 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 AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Mission Arts Design Group 2 Raymond Drive Carmel, NY 10512 Attn: Jason Mitchell Dear Mr. Mitchell: DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health April 21, 2008 Re: Addition — Application Incomplete — Wunner 50 Jasper Road (T) Patterson, TM # 36.56 -1 -16 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. The following was not submitted with your application: 1. ..One set of sketches of existing floorplans showing existing conditions 61y. •The - plans must reflect all floors in the house, including the basement, with all rooms noting their dimensions and use. The plans must also be noted as existing showing owner's name, address and tax map number. Upon a receipt of a submission, revised to reflect the above comments, this application will be considered further. GDR:kly Sincerely, i Gene D. Reed Sr. Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 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 APR-29-2008 16:12 MISSIONARTS DESIGN GROUP 8452282594 P.02 [11% 12'-D" x 14'-4" 1 PORCH DN `/fin x T-2" J CAW& 21KII up to, 41 7 4 1 ILI 11. 111 1 PA PANMY _. 7 _.____. Zi 127-11. BATH > N C5 CD = cc Lu 0 40 w C'- m x IV-10 ..h�l C) Lu LL- m t I C) C) F-- ZE 1 1 z C) CS 8 Le CL Lu �O - 2 -- rc.— F— 0 IV) cr- Ui LLJ m cc + CL Lu < Lu C 8) t� S a- Cl F- 11) Cr 241'-5" x 15'-S" .::r C'g E F- =:) ZZ Lu CL __j U) a- co Lu =D cn cf) r:xISTINC, STRUGTURZ PRO P05E 0 F I R5T FLOOR FL AN SCALE: IAW ■ V-0" . ( 4.:N.06 WUNNER RESIDENCE TAX MAP No. 36.56-1-16 Mis,,,ionArtsDesi R..yiw,,J D- I 14, TnT01 D M) z 0 ON rn rTl W-W zL C) C) O rn m x Z L13 O rn O 2q'-4" 5TFa-X7LWE BE -LON +/- 24'-b" 0 00 0 2s Im 0 (D X- 0 co) 0 OMM OF "IST111, T PUTNAM COUNTY AR MET OF HEVLT—H L HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS A L— — — — — — — — — — — — — — — — -- ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL SICKATUk-E & TITLE DATE t I r ^ b H O W G� t t H 01\ ll, MM z� �T z; d ^_ -, G D I--a I— En o? a art, N O rn rn z W t O m k N v; N rn W t O I Fl—if I quern �X /V O —� - A (( yz I - - - - -- o � rn > z CXISTIN6 DROPPED BUM— — — rL Y I I I I I I J �— — — - PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BE ONLY 02 BEDROOiV1S A ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE HOUSE PLMIS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL TURE & TITLE I +/- 29' -4° +/- 24' -8" r---------------- - - - -�— r I_ � DROPPm STEEL BEAM ' a rn J z — — DROPP[p 9TEl:l BLAM — — Tj I:I UM4p-17r@j e 10 I I 7 3 9 I— — I -- DROFPm 5T @L BEAM — — Ir:I Iii LL ---------------- - -- -J- +/- 24' -8" W t 0 9 • +/- 501-00 V3' -!2° &I—Oil F R 0 F 0 5 E D F I R 5 T F L 0 0 R F L A N SCALE: VW= I'-O" WUNNER (3.21.06) F MissionArts Desisn GroL RELOCATED DO RELOCATE RELOCATED LIVING ROOM c TAX MAP No. 36.56-1-16 IMF KITCHEN x 16-4") KITCHEN Fi, J,.�Sz.W Ry—,.d N� Ph.- 2+5.228. C.-J,Nyoga F- a+5.2u - am (12--0" x 14--4-) 11 LI PORCH + + CLST• DN FOYER HALL x T-2") CASUAL DINING 0 UP C 1TT• PANTRY, PANTRY REN. BATH (10 (10'-O"xT-11") PININ6 ROOM (15-5" x 15-10") stave. (10'-0" x 5'-1") IT t e AMILY ROOM F �r (2q'-5" x +/- 501-00 V3' -!2° EXISTINS STRUCTURE F R 0 F 0 5 E D F I R 5 T F L 0 0 R F L A N SCALE: VW= I'-O" WUNNER (3.21.06) MissionArts Desisn GroL RESIDENCE it 'A,chit-t—, TAX MAP No. 36.56-1-16 IMF Fi, J,.�Sz.W Ry—,.d N� Ph.- 2+5.228. C.-J,Nyoga F- a+5.2u - am { t 1 N 1 t 1 t ri— - -- .— — — - — - — — — — —7 — — OL T. I I o, BEDROOMI p x IB -10 ") _s LIN. _ p MASTER BEDROOM (13' -I" x Ib' -4 ") ow I .Be V • r I I + u. I� HALL SIN I I h BATH I Tls I - I I o I PROPOSE D P.^MF BELOW ... . : ._ _ ROCF BELC % -. zt I . OUTLINE OF EXISIN6_ WiiTE URE BELOW t/— 30'—O" EXISTING STRUCTURE 5 EIf, O N D F L O O R I WUNNER T RESIDENCE TAX MAP No. 36.56 -I -I6 t 1 t P L A N ( 52,.08 ) MissionArts Design Group inc. d1 �+3il�,vcr> UFSI('N c'aar Pr•., sage Y R.,ymu°d D n , P6— 845.443.4333 C. —I, Vyi-si4 F— 845.443.250./ 4 0 v N \ t t 36' -0" i �I �I -------- - - - - -i i------- - - ---- I I I I I I I I I I I i I I I I 1 I EXISTING STRUCTURE FRO FO 5 E D B AS E M E N T SCALE: 1 15" = 1' -0" WUNNER RESIDENCE TAX MAP No. 36.56 -I -I6 3' -0" P L A N a c i (3.2-7.08) I t y lissionArts Design group inc. 'A,: 1—.:e.,. ," . F1... 5:.1.' Rf5 0MMCNA1)F,SI('N00JIrIK:. aY 2 R y-.J [.ham P6- 345.443.2333 C-,—[- VYrosi2 Far s4s.222.2su APR-23-2008 11:54 MISSIONARTS DESIGN GROUP 8452282594 P.02/03 r: EXISTING EXISTINO LIVIN5 x EXISTING STRUCTURE E X 1 5 T I NCB F I R 5 1 F L 0 0 FZ F L A N SCALE! l/W ;; 1'-,0' 5.2-1,08 WUNNER RESIDENCE -tA,"X MAP No. 36.S6-1*-16 I. I EX -- 1 1 - Q C EXISTING KITCHEN EXISTINO x BEDROOM ,#I. L=—j t.-EXIST, (BATH lal -t--1 GL I. EXISTING EXISTINO LIVIN5 x EXISTING STRUCTURE E X 1 5 T I NCB F I R 5 1 F L 0 0 FZ F L A N SCALE! l/W ;; 1'-,0' 5.2-1,08 WUNNER RESIDENCE -tA,"X MAP No. 36.S6-1*-16 APR -23 -2008 11:54 MISSIONARTS DESIGN GROUP 8452282594 P.03iO3 Ti 5T111 M n7 I- I t I� a m I � EXISTI.MS TWa 6AF2 I i II I� I j CSAR.A&E I , + I � II / Irr- -__ I -__ter r_I I - -_ rr.- _- I I -_ -___ I I . I I _ EXI�aTIN6 STRUCTURE EX1571 N(5 E3A5EMENT FLAN WUNNER%v�is�:�.►Ar Design r�up RESIDENCE inc- o au.�nwr iraxw �n].•s+•..K TAX MAP No. 36.56-I -I6 Ti 5T111 M n7 2s ter" PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES �� DESIGN -DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner �/UrU,U i2 Address Located at (Street) Tax Map3G,56 Block_ Lot (indicate nearest cross street) Municipality P r WatershedT gar_ -H SOIL PERCOLATION TEST DATA Date of Pre - soaking 5 2'7 Lo 7 Date of Percolation Tesf _j �30 o;y NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test.hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 2 3 1o,J.7 - /o, #o 13 azZ 4 10" oi 13 4z' -3 5 _ 2 I lo: 3 9— //,'0 7 30 2 S- -t 7 3 u:rr- ii: �r 340 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test.hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 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' 10.0' TEST PIT. DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES 16 of HOLE. NO. HOLE NO. HOLE NO.... Indicate level at which groundwater is encountered j -- Indicate level at which mottling is observed _A9 QAJ Indicate level to which water level rises after being encountered Deep hole observations made by: Dates 30 0 Design Professional Name: Address: Signature: Design Professional's Seal 2 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES a- --� DESIGN DATA SHkET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner \AIU/yd cg Address ; S p,g_:'2 Ra" Located at (Street) Tax Map 34,5'9 Block- �_ Lot 1,C (indicate nearest cross street) Municipality ett�rEiser✓ Watershed 51- 7312��1c�1 -k SOIL PERCOLATION TEST DATA Date of Pre - soaking /p Date of Percolation Test . Z/A Z 04 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 4 5 2 00 3 Ay 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 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' _.. _ M' 10.0' TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST BOLES HOI_.._N-0-. - -- - _:.. .: .. HQLFa NO.__.._ ,�,:.. HOLE NO, - T Indicate level at which groundwater is encountered 41glu,r— Indicate level at which mottling is observed —A 1 Indicate level to which water level rises after being encountered -'- Deep hole observations made by: e5�, 4W.9 S'p. ,cx Date z ®� Design Professional Name: Address: Signature: Design Professional's Seal K _ } ' F £ 3, i 4 � Signature and Title Y.. RFPC) RF•G'FT'VFi RY2 I acknowledge receipt: of this eport SINATUItE; 0,2%96 -: Title, SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 REQUEST FOR FIELD TESTING All information below must be filly completed prior to any scheduling. DATE: 6/2 LOCO ENGINEER OR FIRM:, 1 aig r-owlei— PHONE #:-605 e7e,511-7 0A52-1 PERSON TO CONTACT: % /7/1*" )kNEW CONSTRUCTION El REPAIR PROGRAM ADDITION PROGRAM REASON: DEEPS: PERCS: PUMP TEST: ❑ ROAD /STREET: , 5Zj go 4 TOWN: �?,q ff6iR5m) TAX MAP #• ��e• 1�jr� % L SUBDIVISION: -1;45P kk W, LOT #: yf� OWNER: hhreAd, A)AJ l NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING YES NO ❑ ._....Proposed.SSTS.withinahe- drainage basin, of West Branch or Boyds,C ®rner, &= -: _ . _..__.u. - � - Croton Falls- Reservoirs. ❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. El Proposed SSTS within 200 feet of a watercourse or a DEC wetland. ❑ Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required. ❑ Proposed SSTS for a Commercial Project. It is the responsibility of the design professional to provide the above information prior to soil testing. The Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered ves to any of the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually suitable time for field testing with the Design Professional and NYCDEP. If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. F R g�Y USE ONLY DATE: = 'G VAQ4g - - COMMENTS: 2-9 xv --timC> — /® REQ. FOR FIELDTESTMG:KLY �vironmental Health (845) 278 -6130 Fax(845)278-7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 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 If yes,. what. :is the condition of the fill? "' a SECTION C:: SOIL OBSE VATIO S 10. Appearance of soil: Viand Gravel 6oarn M clay . Hardpan Mixt�ue 11. Observed from: Borings Bank cut f excavations 12. Soil 'borings/excavations observed by 1 RC /f -on i z_ 13. Depth to groundwater on 14. Depth to mottling MOM 6,� on 15. Are test holes representative of primary & reserve areas... ...:Y s : 0 No 16. Soil percolation tests made by on . 17. Soil percolation tests witnessed by , _on SECTION D (on back) Form ST -1 2 SECTION D :. DRAINAGE 18. Will proposed`grading materially alter the natural drainage in this or ad�acertt areas? Yes .. 19: Will groundwa.,er:or surface drainage re: quire sl ecial considerations ........... ...... :. Yes N .. 20. Will galles, ditches, etc ; be filled and watercoursesbe relocated ? ..:.................:.:.. Yes _ No SECTION E. RENIARIS, .21. If a common water. supply is' proposed,,has an inspection been made'of.:the existing or proposed source and facilltieS7 .........: ........... .......... .. ..... Yes No Inspection -data 22, Do adjacent-wells'and /or °sewage systems exist ?....::... ....................... .. ..: Yes 0 No. 23. Additional comments ' 24. Site observer /.inspector .and title 25. Date(s)-of observation(s)inspection(s) 7` `D& TEST PIT PROFILES �- Hole # Lot # Hole # Lot;# Hold # Lot # Depth to water Depth to water Depth to _water. _ --:-Depth to-mottling---- ` _.__ "Depth to mottling ' Depth to. mottling Depth to rock/irnp. Depth to rock/imp: Depth to rock/imp , . G.L. G.L. 0.5 .0.5' 0.5 1.0 1.0 1.0 2.0 200 10 3.0' b 3.Q :.;. 3.0' 4.0 4.0 4.0 5.0 5.0 : 50 6.0 6.0 6:0 7.0 : 7:0 7.0 8.0 8.0 8:0 9.0 9.0 9.0 10.0 10.0 10.0 JUN -02 -06 01:24 PM FRANK G FOWLER 9143697819 P.01 - .SHERLIT -A A-M 1: :ER,,'MD.•MS.-,FAAP Commissioner of Health LORETTA MOLINARI. RN, MSN Associate) C'ninmis ;sioner.. g1'Heahh �FiOlERT J. -O NDI I.ULrt{t' l..1'rc•ufivr ROBERT MORRIS, PE Director of Em4ronmental Health DEPARTMENT OF HEALTH I Geneva Road, Brewster. New York 10509 REQUEST FOR FIELLZ TESTING All information below must be completed prior to any scheduling. DATE: ENGINEER OR FIRM: �� PHONE #: � e7e A� PERSON TO CONTACT: 1P:P;V17je, KNEW CONSTRUCTION ❑ REPAIR PROGRAM ❑ ADDITION PROGRAM REASON: DEEPS: ❑ PERCS: !] PUMP TEST: ❑ ROAD/STREET- TOWN.-____1P4 lft -A 5a/V _ TAX MAP #: SUBDIVISION:_ - '1.L7 J� -: — I.OT #: 6 Y OWNER: /'YC1��(rtl��JnIF1Z 06t P 9d� D NYCDDEP CRITERIA FOR JOINT REVIEW AND WITNESSINQ OF SOIL, TESTING YES NO _ -.... Proposed 5S'I'S within the drainage basin of West Branch or Lloyds-_Corner &� Croton Falls Reservoirs. r Proposed SSTS within $00 feet of a reservoir, reservoir stem or control lake, 3 Proposed SSTS within 100 feet of.a watercourse or a DEC wetland. n Proposed SSTS design flow greater than 1000 p 1lons /day or SPDES Permit required. r.; Proposed SSTS fora Commercial Project. It is the responsibility of the design professional to provide the above Information prior to toil testing. The Department will determine the NYCDEP project status (Joint or Delegated) based on the respaonst:. If you ansis erect Zev to any of.the questions, NYCDEP must witness the soil tests. This Department will coordinate a mutually Suitable time for field testing with the Design Professional's ad NYCDEP. If a proit= -r has been determined to. be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of the design professional to schedule re- witnessing of the soil testing with NYCDEP. USE UN L}. _ I MATE; — TIME; CO�t:'1lt';NI'S• e-el Environmental Health (945) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225-5186 Fox(845)225-5418 Nursing Services (845) 278.6358 Fax (845)278 -6026 WIC (845) 278.6678 Nursing Home Care Fax (845)27R.6085 Early loterventlon /Preschool (841) 278.6014 Fax(945)278-664H -- J TI e.1_a_aRl r- L7DT 1D.10 TCI .O/IC_'J70_7004 AVIMC.01 ITAVIM Fill IA ITV MffMe%0TMCAIT rlr- Cl 4 M C Ja l LORETTA MOLINARI 4� ROBERT J. BONDI Public Health Director � Y � County Executive DEPARTMENT OF HEALTH I 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 (84.�) 278 - 6014 Fax (845) 278 - 6648 iu To: Design Professionals submitting plans to Pu am County Health Department From: Michael Budzinski, Director of Engineering6 Date: January 26, 2004 Re: Sail Testing The Town of Carmel Environmental Conservation Board (ECB) has informed this Department that they have been encountering developers who are accessing properties to excavate deep test holes in proximity to local wetlands regulated by the Town of Carmel. The ECB has informed us that it is a violation of the Town of Carmel Wetland Ordinance to undertake any activity within the 100 foot buffer `of a wetland or water body without first _ obtaining aAetland-permit:from the ECB... . To address the concems of the ECB; all projects in the Town of Carmel, which will require the witnessing of soil testing by this Department, must first be submitted to the Town of Carmel ECB for review. This Department will not schedule field testing for projects in the Town of Carmel until the ECB has reviewed the submitted site plans. The ECB will provide this .Department with either a: 1. Letter of Permission stating that the, ECB has reviewed the site and that no wetlands exist and, therefore, test holes can be dug. Or; - 2. Letter indicating that the project will require a wetlands application and, therefore; no- test holes can be dug until a permit is granted. . This Department is also requiring the submittal of an engineering plan prior to the scheduling of any soil testing within Putnam County. The submitted plan .shall* include, as a. minimum, the following items: a. Property survey with metes and bounds descriptions and. major physical features. The plan shall make reference, by note,-of the survey source and in�the case of lots not subject to a filed map, a certified copy of a survey shall be provided. 1 t b.. A datum reference is to be provided (i.e., National Geodetic Vertical Datum 1929, or assumed/other). __.. c.. ._..Proposed. hcuseor.building, driveway(s) or road(s),_weLI,.S�TSe and aLl�otber_propose improvements. d. Two -foot contours of the property. If ground is to be cut .or filled, both existing and proposed contours must be shown. e. Location of any water courses, ponds, lakes or wetlands on, or within 200 feet of property: f. Location of all existing wells and SSTS within 200 feet of proposed SSTS and well, or a note stating that none exist within 200 feet. g. Delineation of Uhited States Department of Agriculture Soil Conservation Service soil type boundaries. h. Location map (minimum scale of 1" = 2,000'). i. Title box indicating name and address of property owner; parcel tax map identification number-,.property location, including street and municipality; name, address and phone . number of Design Professional; date, of drawing, including dates of any revisions; and scale. Please be advised this Department will not schedule field testing without an engineering plan as specified above. Should you have any questions concerning the above, please contact this Department.. MJB:cj Cc: Town of Carmel ECB • Page 2 SENDING. CONFIRNATION DATE : JUN-6-2006 TUE 08:40 NAME : PUTNAM COUNTY DEPARTMENT OF HEALTH TEL 845-278-7921 PHONE : 98784031 PAGES : 2/2 START TIME : JUN-06 08:39 ELAPSED TIME : 0015611 MODE : ECM RESULTS ' OK FIRST PAGE OF RECENT DOCUMENT TRANSMITTED.. LOR=A MOLD;= M11IMT J. BoNDr PWI, MI.&* Df—,, –y arlt DEPARTMENT OF HEALTH GcOck k006, B—sta New Yo* 10509 6nvrra6tpwpl Hmk! (847)1 111.6170 Fos (114S)Z71-792i N.'W.11 sWv1.7 (845)275-6551 WtC(M5)279-667A' Fa(US)278.6olls 9-V 1nt--M-dffl-d=l (W) 279.6714' Vtz (045) 278. 6649 Morro lb:- --Design ProlosWcnalsetibmiliting piers to p WTarh county Health Department FroW Michael Budiinikl. Obiclor of Engineering Data: January 26,2004 Re: gall Testing The Town of Carmel Environmental Conservation Board (EC13) has Informed this Department 71st they have been encountering devoT 'o PQrs who are accessing properties to excavate deep test Hales In proximity to local wetlands raVlated by the Tom of Carmel. The FCB has informed us that it ;a a violation of the Town of Carmel Wound Ordinance to undertake any activity within the 100 toot buffer of a wound or water body without first obtaining a wetland p6mritfrom Die. ECS, TO address ft cOrIcOms'Of the R08; al Projects In the Town of Carmel, whoi will require IN witnessing of $oil testing by this De0enment; must Ilrort be submitted to the Town of Camel ECS for review. This Department will agt_ schodule field testing for projects In the Town of Carmel until the ECS has reviewed the submitted alto plans. The ECS YAP provide this Department with either a: 1. Latter of Permission stating that the _CB has reviewed the site and that .10 wetlands exist and. therefore, WS'holes can be dug. Or: Letter indicating that lie Project will require a wetlands application and, therefore; no test holes can be dug until a permit is girarred. This Department Is also requiring the Submittal of an er*mringplan prior to the scheduling of any still testing within Putnam County. The submitted plan sholt include, as a minimum, the following items; a. Property survey with Metes and bwnds descriptions and. major physical features. The plan shell make refarenep, by note, of the survey source and In the case of Iota not subject to dfiled map, a certified copy of a survey shall be provided. FRANK G. FOWLER, III Engineers • Surveyors • Planners 72 South Rd. HOLMES, NEW YORK 12531 TO /IM) ILIET [En W M° MMQ` U&I DATE r� JOB NO. "ATrENTIO 2�,1� ECG -S�• WE ARE.SENDING YOU ttached ❑ Under separate cover via the following items: ❑ Shop drawin ❑ Prints ❑ Plans ❑ Samples ❑ Specifications ❑ Copy of letter ❑ Change order ❑ COPIES ATE NO. DESCRIPTION AV ..:THESE ARE TRANSMITTED. as checked below %. - . ❑ For approval r your use ❑ As requested ❑ For review and comment ❑ FOR BIDS DUE REMARKS • Approved as submitted ❑ Resubmit copies for approval • Approved as noted ❑ Submit copies for distribution • Returned for corrections ❑ Return corrected prints ❑ PRINTS RETURNED AFTER LOAN TO US COPY TO SIGNED: If enclosures are not as noted, kindly notify us at 1f f Ej 1 Y r t; 52ruorms ONLv" s dr:0a7dl bawl - 000L'69 wr 1 M WNOOr#WJ NM42W,5L- W)OZ'b1.MV f __ JOAVa 5J1 2.11- W "Jtki NgVJ3WH -Oaocu 4,00Z 01F[7gAX�J•AM /.y t sau arcs A'N "07 VV)VWd N05�lallv.A -AO w0.6 vACrJdWSw aon TlnS aancvddJS✓ YYid 3LL iO NaKNHaO El711V1,1O01Y'81SVDa'ZMhD.v7J NI 21M'LLK vAVa au NO`.GbAM Ad 64:J." dO fW01 3u J7 �� Ofd'fArW ]u JD NOINI'105O 1D dd"[RWM A,400M Nad5vr JOlvld N015W'10,6 ImId" e NO IWv10H5 5v 1 '}/AOJId.N GH/OG 7PAJf-N1d NoQr"wJ JO WCU o 1 6 'SON --O-1 N3WUV ZN,AW15nl -6V �JNII JO 1 _ :.bt'L "r b.jpl pyOdOy 'Alfd 2X,A2WJ AMR" WMAY Z %'O O'b'IY I OI. !� d75N71SIKWd A W W111G'D�Y1im JON Q.WU 90" WAMW J01 QXd10Lid 1 W-W2i JOJNM;WAa AWWVWWWdu JO -WtMi /w S13Y407 IY00 I 8711 nV.�1ZH/J I 'aAVMAOJZa'W]AVMONMJMS 'Y1WX1W;ON51'1mOA1 dvl'Mil NLTIN J110W 3LL b 411 NOUOX QM'MYl WT:a(JI17W du b sYI NOWX NI � Sy POWO" JO NOWNJiJ au NNIY.1 TWJ JON j 6afi I 9(JS'SY klOi RiKNi ! 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