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Home My WebLink About4824DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13.07 -1 -41 BOX 6 01001 IN his 16 A y kc T , 16 L 01001 el PUTNAM COUNTY HEALTH DEPARTMENT �% ca,►� DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAIR YES NO Z Internal Use Only PERMIT # ❑ � Repair Permit issued in last 5 years ❑ Not in Watershed ❑ Repair within Boyd's Comers, W. Branch or Croton Falls Res. D @legated 11 Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION OWNER'S NAME MAILING ADDRESS APPLICANT DATE OLUP` - Name & Relationship (i.e., owner, tenant, contractor) FACILITY TYPE /Q is PCHD COMPLAINT # PROPOSED INSTALLER -75 4 U PHONE # ADDRESS REGISTRATION /LICENSE # Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system). NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and xtent of the repair. l� R6oc. Ottl'fio0 191P� "Si.k + � p I, as owner,agree to the conditions statoftn this form SIGNATURE C��1✓�! TITLE 6120 Jy� DATE j Ll (owner) I, the septic installer, agree to comp (y with the conditions of this permit for the septic system repair SIGNATURE TITLE DATE pnstaller) Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfilled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved Proposal Denied ❑ Inspector' Ignature & Title D to Expira ion Date Repair proposal is in compliance with applicable codes Yes No ❑ COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 From: Pierro, David Sent: Monday, June 18, 2012 3:09 PM To: crisdellarippa @putnamcounty.com Subject: pierro survey Cris, Please find attched Davird, Dawn Pierro Survey labeled Dwyer. To the best of my knowledge I have a 1000 gal tank off of the Southeats side of the residence with fields in the rear yard. I am supplied with water from Cornwall Meadows HOA by easment. Thank. You for your attention to this matter, David Pierro 845 494 6954 REBECCA WITTENBERG, RN, BSN Public Health Dbedor ROBERT MORRIS, PE Director ofEmiromnadd Health MARYELLEN ODELL cowdy Reecudw DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 : Fax # (845) 278 -7921 TO: NYCDEP DEPARTMENT OF ENGINEERING AND DESIGN REVIEW ATTN: T FROM: C DELEGATION STATUS FOR SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM DELEGATED New Application Renewal 0 PROJECT: V e—rr(-) LOCATION: TOWN: rc;� DATE SUB'D APPROVAL TM # NOTICE OF COMPLETE APPLICATION DATE: DELEGATED Putnam County Department of Health Division of Environmental Health Services SSTS Repair —)din Site Ins )gdon Date: ` Inspected ' icy. r Installer. Street Location: 'v� �, Owner. Town: �c: Repair Permit #: 1 _ TM # / • 7 •— / _ •--- -_ 1. .1ype or bysum: c.:onvennonal-U Alternate U Comments: Tank Yes No N/A Comments ptic tank size —1,000 ...1,250... other .... . ptic tank installed level ...................... 7d, ' minimum from foundation .................. stribution Box i. All outlets at same elevation (water tested) ... ii. Protected below frost ................ .... ....... iii. Minimum► 2 ft. Original soil between box & trenchesj� e. Jandion Bog — set ............................ L Trenches i.. Systed completely ened for inspection H. Length required Length installed iii. Pie slope checked ... ............................... . iv. Installed according to plan ..................... v. 101 from property line — 20 ft — foundations ... vi. Size of gravel % -1 V. " diameter clean ......... vii. Depth of gravel in trench 12" minimum ......... viii. Ends capped . ... ............................... R. gov or Dosed Systems 3. SEW Systm Area L SSTS Area located as per approved. plans b. Fill, section — c. Distance from water coursetwetlaads 4. Overall Workmanship a. Boxes properly grouted and installed correctly .......:... b. All pipes flush with inside of box ........................: c. Backfill material contains stones W diameter ......... d. Curtain drain & standpipes installed according to plan V e. Curtain drain outf dl protected & dir to exist watercourse f. Footing drains discharge away from SSTS area ......... g. Erosion control provided ............................ Additional Comm, : PARCEL' . 3. B5 '37 100 N. B5 °37'Gb "E. S. 4 °23'00 "E. 17 50' . 24./0' M we// u a S 4 °23'00 "E.. /09.97 g h F a .� .�• O� '�h s a, ,, 44's t p°irh, �. 3, House . [1Z .1 N 2.040 37 "W. N 3-12'07"W.. o u 1544' W h \ CORNWALL HIL4 ROAD i rouNry HIGHWAY) W k § \ t tit cI r _ =�z {5S's`� yy I �x.s4'A:: "auto eal Estate Affiliates. Inc. . 4• s• �i * �v:.rcrl:.* I Property Details - Image Mate Online Putnam County A6G Image Mate Online Page 1 of 2 Navigation GIS.Map I Tax Maps 1lRPS Links, Assessment Info [Help l;og In Residential Property Info Owner /Sales Inventory_ Improvements. Tax Info Report_..._..... Comparables_, Municipality of Patterson, Town of SWIS: 372400 Tax ID: 13.7 -1 -41 Structure Building Style: Ranch Number of Baths: 1 (Full) - 1(Half) Number of Bedroom 2 Number of Kitchens: 1 Number of Fireplaces: 1 Overall Condition: Normal Overall Grade: Average Porch Type: Porch Area: Year Built: 1954 Basement Type: Crawl Basement Garage Cap.: 0 Attached Garage Cap.: 504 sq. ft. Area Living Area: 1,858 sq. ft. First Story Area: 1,858 sq. ft. Second Story Area: 0 sq. ft. Half Story Area: 0 sq. ft. Additional Story Area: 0 sq. ft. Three - Quarter Story Area: 0 sq. ft. Finished Basement: 0 sq. ft. Number of Stories: 1 Photoaraohs No Photo Available Ma View Tax Map. Pin Property on GIS Map View in Google Maps View in Yahoo! Maps View in Bing Maps Map Disclaimer Property Details - Image Mate Online Utilities Sewer Type: Private Water Supply: Private Utilities: Electric Heat Type: Hot wtr /stm Fuel Type: Oil Central Air: No Page 2 of 2 Property Details - Image Mate Online Putnam County Navigation GIS Map I Tax Maps Residential _,Property_ ,Info_, .Owner /Sales .Inventory_, __. Improvements Tax Info. Rep_ortV Comparables,. A6G: Image Mate Online Pagel of 2 ORPS Links Assessment Info Help Log ] Municipality of Patterson, Town of SWIS:1 372400 Tax ID: 1 13.7 -1 -41 Tax Map ID / Property Data Status: Active Roll Section: I.Taxable Address: 444 Cornwall Hill Rd Property 210 - 1 Site 210- 1 Class:. Family Res Property Family Res Class:... Site: Res 1 No District: Zoning Code: Residential Bldg. Style: Ranch Neighborhood: 00200 - School .0- District: Legal Property 00100000050120010000 Description: 001500000000000000107 1 -5 -12.1 2011 - Total Equalization Tentative Acreage /Size:. 1.07 Rate: 100.00% 2010- 100.00% 2011 - 2011- Land Tentative Total Tentative $89,200 $278,800 Assessment: 2010- Assessment: 2010- $89,200 $293,500 2011- Full Market Tentative Value: $278,800 2010- $293,500 Deed Book: 1119 Deed Page: 319 Grid East: Grid North: s No Photo Available Maps View Tax - Map Pin Property on GIS Map View in Google Maps View in Yahoo! Maps View in Bing Maps Map Disclaimer Property Details - Image Mate Online 1734849 1 975050 Special Districts for 2011 (Tentative) Description Units Percent Type Value Fire #1 0 0 0 Park district 0 0 0 Garbage dist 1 10 0 Special Districts for 2010 Description Units Percent Type Value Fire #1 0 0 0. Park district 0 0 0 Garbage dist 1 0 1 0 Land Types Type Size Primary 1.00 acres Residual 0.07 acres Page 2 of 2 .................. --------------------- ........ ....... ---------------------- ....... ----------- --------- -------------------------------- --------------- _--------------- ------ --------- ------- .............................. Be 17 a 20 421 �r --------------- 'T ------------- - - 23 35 28 39 U 34 w lx� I.W GL. c 1.33 AG 10 A�_ .PP mP ROD -------- 4 . 0 28 ---------- 33 US AC, goisi T. y ,s V 0 d 1.02 W- WDA5 4 iM Ar- 59.12 'A ' 1.0 Ar 31 - lm AC. w 10 30 &97 AC. 1.2i Ar- es 12 IWAQ Z83 250-00 P. so 5 IMAQCw Im AC Cu. 6.85 AC. u 4 59 A, 83&13 3 A•s 55.1 --------------------- SWAG M2 x 5&3 IM AM aP memo! ... .. 320 PRELIMINARY 1 MAP 1U7 SCALE V INEEN 13-08 TOWN OF PATTERSON