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HomeMy WebLinkAbout0765DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 24. -1 -59 BOX 9 00765 f No Ir %.I }V - r , a� q I m- tr 1 � I,` L �I ■ `� N r T , . '7 `� I is IN j I IN 00765 St4ERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner. of Health County Executive �. te) J ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road.. Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONJY STREET G-� TOWN TAX MAP # NAME E PCHD# = , MAIL ' G ADDRESS DESCRIPTION OF fOd�Z�_ .3.zt..�. ADDITION�tSrytuvst /rur►�� j�nrlr�vv �v /� / ltiluz�s �� '. NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS_�T (FROM CERT. OF OCCUPANCY OR CE TIFICATION FROM, BUILDING INSPEC. TOR) " *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 Putnarti County Health Dept.,'l Geneva Rd, Brewster, NY 10509, Phone: (845) 278 -6130. 1. Certified check or no ey o 66 Flo W i lOQ'00: 2. `Sketches of.existing floor plan (drawn to scale,. all. living area including basement, to be shown and dimensioned and use. of each room specified). (See Section 3.c of. Bulletin HA-l) 3, Two sets of proposed floor plans (drawn to scale = with name, street and tax map #). *.Non- professional -sketches are acceptable and preferred. (See Section 3.d of Bulletin - . HA 4) 4,.:. Copy of survey, - showing --all well and' septic locations on. the subject property to the'best of your knowledge.. Include date of installation known. Contact this office with any questions.. S. Copy of Certificate of Occupancy from the Town or Certification from the Building- Departmont with legal bedroom count of dwelling. s OFFICE USE COMMENTS 5. Environmental Health (845) 278 =6130 Fax ($45).278 -7921 Water Supply Section (845).225-51-8,6 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (i45)278'6026 , Nursing Home Care Fax. (845) 278 76085 -WIC (845) 278 =6678 . (845)' 2 Early Intervention /Preschool (845) 228 -2847 Fax 25 -158.0 I I i I I i I I I I I F ===- I ( I I I I E ( I I I I t I I _ rte, •.. o I I I I I I I I I L - I - -- I I Il --------------------------------------- - - ---I I I I�J-1 i :A; I I I I LINE OF I ABOVE I ' I I I I I I I EXIST.PORCH I I I ��I WOOD DECK I REMOVE EXIST. POST WOOD DECK \ AND CONC.FOUNDATIO . I C - -D CELLAR FLOOR DEMOLITION PLAN 3/16 " =1' -0" ELEMENTS TO REMOVED EXISTING WALL TO REMAIN I \ II � REMOVE EXISTINO\ EXTERIOR WALL \ 1 I � EXIST. 1 (LOPED 6LKWAY. TO BEI REMOVLD II ARCHVISION D�DN 9fODID CARRIAGE FOR HOUSE N RENOVATION 460 ROUTE 164 PATTERSON NY. N0. DATE W= TO H 0 111 IRE NEW ADDITION DATE; ,u4-15-W SOME; AD -01. ----------------- ----- - - - - -, i I 1 ❑ ❑ o I ' I REMOVE EXIST. i "NE OF WOOD DECK 3OVE GROUND FLOOR DEMOLITION PLAN L' 3116 " =1' -0" LEGEND C = =� ELEMENTS TO BE REMOVED E== EXISTING WALL TO REMAIN. i ST. \ \ NLL \ \ E�(IST.SLO�ED WALKWAY TOO BE R MOVED 1 I y ARCHVISION mom smm CARRIAGE HOUSE RENOVATION 480 ROUTE 164 PATTERSON NY. REMN ; NO. DATE ISSUED TO FA"dlh NEW ADDITION DATE: JAN -15-06 SCALE: 3/I V =1' -0' I I I I I I I I I I I SECOND FLOOR PLAN 3/16 " =1' -0" ill EXIST WOOD DECK 1, -1 I % / I I I REMOVE EXIST. /— `—f—r— WOOD DECK AND 1j 1 HAND RAIL ---------- j; - -`� — ry-------- - - - - -- — ;r 1 I . II UP. UP. II - - - - -- - - 4EP - -- __-- - - - -$� - I (l l Il I �- LAC E EXIST. I� I REMOVE EXIST. \, LMNG ROOM IITT WINDOW AND WALL Ill III I . EXIST. DN. I� I rREIF 14TCHEN / DINING I b I � , I I I 1 -----==---=---=------------ - - - - -I ✓1 LEGEND C = =� ELEMENTS TO BE REMOVED [� EXISTING WALL TO REMAIN ARCHVISION utm smmo CARRIAGE HOUSE RENOVATION 460 ROUTE 164 PATTERSON W. REYMN.; ND.. DATE MO TO N NEW ADDITION DATE ; JAN -15-W SMI ; 3/15 =i' -0- AD -03 i 0 —T - -- &)7 o i I I I n o a i i I Oo 0 I i I I I I II Igg -- - - - - -� I 1 15:1 l I IcH I I i-1 I 11- ' I I I f I I I I I. EXIST.PORCH 17 CONCYORCH I I I I � I I CELLAR FLOOR PLAN 3/16 " =1' -0" CONC.STAIR; 7 RISERS 06%" RISER 11N2" TREAD 7 1 ON o 0 EXIST.BOLLER ROOM 0 NO CHANGE .0 O 0 rn 'Co r-o - 1 ' EXIST.BUILDING LEGEND NEW WALL D EXISTING WALL TO REMAIN CELLAR DIRT FL00R) 5'- ADDITION ARCHVISION D181fd13f0DI0 CARRIAGE HOUSE RENOVATION 480 ROUTE 164 PATTERSON NY. FIVSIM ; NO. DATE ISSUED TO NEW ADDITION DATE; JAN -15=06 SCALE ; 3/16' "1' -0' A -01 -- ----- -= ----- - - - - -- ----- - = - - -- -- -� IF - II NEW DOORWAY I I I I I I I I I I _ I I i III I i I III I I I 1 NEW WINDOW; 5' -0"W. X 8' -0 "H. NEW WINDOW; 1 O"W. X 8' -0 "H. GROUND FLOOR PLAN 3(16' =1' -0" I I PORCH LEGEND 0 NEW WALL - -� EXISTING WALL TO REMAIN A04 NEW WINDOW; 5' -2"W. X 3' -8 "H. ARCHVISION �i d � i DOOR - 111 hI �■ m �_ ■I .,DODO �� II PLAY .. ,--�% STAIR I_ I i GROUND FLOOR PLAN 3(16' =1' -0" I I PORCH LEGEND 0 NEW WALL - -� EXISTING WALL TO REMAIN A04 NEW WINDOW; 5' -2"W. X 3' -8 "H. ARCHVISION I- -------------- • I I - - - - -J I-------- - - - - -- —i- EXIST, I MASTE"EDROOM L : C L 4 �'' SHOWER' ® BA1HR001 EXIST. F: MASTER BATH M 0 EXIST. BEDROOM BATH TUB CIL nom EXIST WOOD DECK %Y %Y / • ..i � '11 I� ' 11 �I:...i■.illla■ ARCHVISION o�ea sromo NEW WOOD HANDRAIL TO MATCH EXIST. NEW WINDOW; 5' -5"W. X 6' -10 "H. 480 ROUTE 164 ■I ■i��l�i %i PATTERSON Amm NEW ADDITION - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - J' - - - - - - EXIST.BUILDING EW A[ SECOND FLOOR_ PLAN 3/16 " =1' -0" LEGEND ® NEW WALL C� .EXISTING WALL TO REMAIN � NEW WINDOW; 5' -5"W. X 6' -10 "H. o^TE wi is o6 SGIE :3/16' =1' -0' A -03 i I I I I I I ExIST? I. i MASTER DROOM I I , '----------=---------- - - - - -- ,6-�X I ST/ AJ (!� SECOND FLOOR PLAN 3/16' =1' -0" . II Il l 11 V EXIST WOOD DECK I 1 A I I Ir I I I I REMOVE EXIST. /-V-1-F- ,WOOD DECK AND ;I i r 11 HAND RAIL II II A I11 II II II I .r1 1 UP. UP. 1 - - - - -- -- �?--- - - - - -- I'I ' III I I JJ ! O REPLACE EXIST. III I. REMOVE EXIST. LMNG ROOM II)-I WINDOW AND WALL III DN. III F IEXIST. I I REF' KITCHEN / DINING I . I TP o RI I I I i --------=------------ - - - - -J LEGEND C = =� ELEMENTS TO BE REMOVED C� EXISTING WALL TO REMAIN mma now CARRIAGE HOUSE RENOVATION 460 ROUTE 164 PATTERSON W. REVO N.: NO. DATE ISSUED To N NEW ADDITION. DNE; ANN -15 -06 SCALE: 311V-1' -V AD -03 ------------------ --- -------------- - - - - -, I I I❑ ❑ ❑ ❑ I • -I _ I REMOVE EXIST. I I GROUND FLOOR DEMOLITION PLAN 3/16 " =1' -0" LEGEND C = =� ELEMENTS TO BE REMOVED L� EXISTING WALL TO REMAIN NL OF WOOL) OLGK BOVE 0 ST. \ \ 4LL \ \ E�IST.SLO�ED WALKWAY T BE R MOVED I I I r r/ .y ARCHVISION DEMI SrUM CARRIAGE HOUSE RENOVATION 4130 ROUTE 164 PATTERSON NY. REVISION ; NO. DATE ISSUED TO PA"dak NEW ADDITION DATE; JAN -15-06 SCAE ; 1 li I I 1 I I I I i I. I I I I I i I I I I . I I ° I I I I I I I I I I I I Il I-----=----------------------=----=-------------- - - - --I ARCHVISION I I osysN ammo j Hi i)EQ iy{i I I LINE OF WOOD DECK ABOVE I I I I I I I I I EXIST.PORCH I I � I I I I CARRIAGE REMOVE EXIST. POST FOR HOUSE \ WOOD DECK \ AND CONC.FOUNDATION RENOVATION \ 460 ROUTE 164 PATTERSON W. II \ REVISION NO. DATE ISSUED TO EXIST.BOLLER ROOM I _.REMOVE EXISTING, \� (NO CHANGE I EXTERIOR WALL \ I o ❑ 0 O o � I EXIST. LOPED 6LKWAY. II TO BE REMOVED ❑ ❑ I� co co 0 =T NEW ADDITION E— xlST!"4 - P CELLAR FLOOR DEMOLITION 'PLAN 3/16 " =1'-0" srJUF: 3 /IS' =i-o' LEGEND C = =� ELEMENTS TO BE AD -01 REMOVED C� EXISTING WALL TO REMAIN r-------- - - - - -- I I I I I I MASTE EDROOM I / \ I / \ I / ❑ L CL: I I , L------- - - - - -- h� SHOWER ® / /�✓ 4 ter' wI n &7HR001 EXIST. MASTER BATH M EU EXIST. BEDROOM BATH TUB" CL I AR[- U NEW WOOD HANDRAIL TO MATCH EXIST. EXIST WOOD DECK NEW WINDOW; 5' -5"W. X 6' -10 "H. it NEW ■■1 DOOR; - / EXIST.UVING ROOM L� EXIST.KITCHEN DINING ROOM iiili /iii •'- - -..,. �........... . °_ _ z. 1 ii 460 ROUTE 164 PATTERSOWNY. Ild w IN ■ s r_-• w ��r■./ ------------ - - - - -- - - - - -- 1� -------------------------- ------------ - - - - - - /l EXIST.BUILDING kEW AE j�1Z0 �OSE� SECOND FLOOR PLAN 3/16 " =1' -0" LEGEND ® NEW WALL O EXISTING WALL TO REMAIN NEW WINDOW; 5' -5 "W: X 6' -10 "H. aTE -ts os m ------------ --- -------------=----- --- - - -' ---------------- - - - -�I NEW DOORWAY I I I I I I I I I I 1-- --- - - -I,I I I I —. - - -- I.II I I I III I I NEW WINDOW; 5' -0"W. X 8' —O "H. NEW WINDOW; 13'-0 "W. X 8' -0 'H. `PT 2co`pOSf-P GROUND FLOOR PLAN 3/16 " =1' -O" I j�j I o "'-- ENTRANCE .c PCH OR LEGEND - ® NEW WALL. EXISTING WALL TO REMAIN ARCHVISION D1c�sTlsroDlo CARRIAGE HOUSE. RENOVATION 480 ROUTE 164 PATIERSON W. FMVWN; ND. DATE MAD TO A04 N NEW ADDITION NEW WINDOW; 5' -2"W. X 3' -8 "H. DATE: JAN -15-06 SOME; 3/16' =1' -0- 1 ���I� � �� �� . • • •�' / / III � • 1 II ■ ■ DOORWAY; - •I 1 III III i FAMII I ;,Illy •,1 I � - EXIST. I� � __ ■ . I / / / / / / / / /// �:.�:� % % / / / / / / / / / / / / / / / / / / / /ii% `PT 2co`pOSf-P GROUND FLOOR PLAN 3/16 " =1' -O" I j�j I o "'-- ENTRANCE .c PCH OR LEGEND - ® NEW WALL. EXISTING WALL TO REMAIN ARCHVISION D1c�sTlsroDlo CARRIAGE HOUSE. RENOVATION 480 ROUTE 164 PATIERSON W. FMVWN; ND. DATE MAD TO A04 N NEW ADDITION NEW WINDOW; 5' -2"W. X 3' -8 "H. DATE: JAN -15-06 SOME; 3/16' =1' -0- 1 NEW WINDOW; 5' -2"W. X 3' -8 "H. DATE: JAN -15-06 SOME; 3/16' =1' -0- 1 0 --T- - -- - I j I I O � I n 0 I I I I O � I I I it t'�Tzo��ET7 CELLAR FLOOR PLAN 3/16 " =1' -0" ----------------------------------- EXIST.PORCH ❑ ❑ EXIST.BOLLER ROOM NO CHANGE 0 1f CONC.STAIR; 7 RISERS - ®6 %" RISER 1U¢" TREAD r� EXIST LEGEND ® NEW WALL O� EXISTING WALL TO REMAIN 7 CONC.PORCH CELLAR n7 twr n nnoi 15'— ADDITION ARCHVISION mcm mmo CARRIAGE HOUSE RENOVATION 400 ROUTE 164 PATTERSON W. FEVISION; NO. DATE ISSUED TO NEW ADDITION DATE; JAN -15-06 SOME; 3116' =i' -W A -01 • JI � fLt7tiLD \ / / o cca- j FRAME 3 0 0 -E0 % so3401,� M i S71 ADDITION rw 05T lA� vo, AAO 6ArW'R'I CA -- - - - -11 EM.MMONI I - ( A1C v4 A-e 2 Ll CARRIAGE HOUSE - RENOVATION 460 ROUTE 164 PATTERSON NY. NO. DATE BSUED TO NEW ADDITION DATE; JM -15-06 SCALE: NIS. A -00B .. S': ' '• :' •. � fin, ti' '�.. ,.. .�^ PUTN AM COUNTYf PRMEN ll OF HEALTH EAT ,Division of Envifonmental Health Services Carme% .N Y: 10512 WNSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM_ ppitterson Briar `Follow Farms, 'Route 164 TOV!T -19 .s Section 'Town orBVillage; j Located : at lock Subdivision n/a 1�4 acre: f a rll... Lot,- Job 1 1 AnG f4l 194 owns, Mr. J.L,. S-teckler Address 1601 Beverly •Road . Brook I an NY � Converted Barri. got Area art of 12.4 acre farm, no subdivision B 'uilding Type - , Two. q et Number of Bedrooms Total Habitable .Space,+ e s S than 1500 square Fe 750: Separate Sewerage .System to consist of Gal. Septic Tank `84 lineal 'feet X `� 0 width trench To be constructed by tO YJP detf3rmined Address Water Supply: Public, Supply 'From -- Private SuP,PIy- to be .cDGMK 3C SUt]nl i Pty her_ "�xi at-i ri wet 1 -nn " aite senrining Adore "ss main 'YlOLtS.e alSO other Requirements • . _ Teeken(d retreat not internded to be used as . a full_. time, dwre113n �I represent that l am wholly and completely responsible fpr.the design and 6cation ofi the *proposed system(s);' '1) that the separate sewage disposal system above described will be constructed as shown on the. approved amendment there tojand in`accordance with the standards, rules an regulations o e Putnam County ,-.Department of* Health, and that on completion thereof a "Certificate of : Constructibn �Conipliance ",satisfactory to the Commissioner of Healthwill be 'submitted to the Department, :and. a written: guarantee will -,be furnished the owner h)s` successors heirs or assigns by the builder, that said builder will ' ;place,,in, good operating 'condition,any' part of 'said ;sways disposal system during the period of two (2) yearsimmegiately following .the date of, the issu- },ante: of the approval of; the Certificate -of .Construction Compiibncex ot�,,,fhe on final ' st, firs thereto;, } t r �pj{1��1j (• 1 a�ldEJ�p 49�J5j �a�, r i ir�li 4 I XS r 'Date­ Au�;t78t'. 1 ®a 1972 g P E X R.A. ! ed ; lt S Address own.RoadYRDy 50. I3rev� er, '.Yorks Uq 43952 APPROVED FOR CONSTRUCTION This approval expires one year from the date._issued.,unless construction of ttie building ties been undertaken and is revocable for. - use oY may' be amended or modified when''considered necessary,ay ttie' Co issioner of Health. •',Any change or' alteration of construction requires a new permit. Approved for disposal of domestic son s!�!a e'a'n�d or pr ate Ater •aupply, only p Date_ ~� f BY ��' 1 " l Title Gentlemen: PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Re: Property of Date Mr. J.L. Steckler Located at Briar Hollow F arms, Route 164, Towners, Pattersoi Section Block Lot This letter is to authorize Arthur P. 1 cLaughlin a duly licensed professional engineer X or registered architect (Indicate to apply for a Construction Permit for a separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgate -1. by the Commissioner of the Putnam County ii TT- Lc o a, and to sign all nece56ary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, •Education Law, the Public Health Law, and the -- Putnam County Sani- tary Code. Very trul' o s Signed o roperty J.L. Steckler Countersigned: 1601 Beverly Load Address P.E., X%)X, # 43952 F- OF y Brooklyn, New York 11226 ,r 1 0< �'r Telephone 9 Address Brewster, New York 10 a �, (914) 279 -6986 Telephone .Q,k ^'0. 4c52 �"ESSIUt3�y 0 1 2 I 3 4 - PUTNA I COL�iTY'DE?z?T:LT OF =.LTH DIVISION OF ENVIRON.rNTAL HEALTH S= ?VICES DESIGN DATA SHEET - SEPARATE SE,� AGE DIS DSaL SYSTEI % FILE 'N0. 1601 Beverly.Road avner ter.. J.L. Steckler Address Brookl7�n, New York 11226.. Route 164 -close to Located at (Street). Couch. Road Sec. Block _ Lot _ (Indicate . nearest cross street) T HE GHAT 'SVIAMP Municipality Totrm of Patterson (TowneT@t)ershed East . Branca, Croton River SOIL PERCOLATION TEST DATA REOUIR D TO- BE SUE.4-TITED W'I.Tft APPLICATION Hole Z g . ``umber CLCC.< TIME PE RCOLaTIOti' PERCOLATION a � Ain Elapse Dept:-: to 'V.17 - ,,.. per [�ra per Level �t ^ : No. Time Frog:,: GroLnd Surface in Inches Soil Rate s Start Stop Min. Start Stoo D_ op in 'fin/in . drop A, o G2oviJ� �,�ruQA�'1� Inches, Inches Inch es e 2.X ® r02- NNt tjG . -r T x 2. !3' 2.1 16 i 3. 4-,4 5 4 1 2 I S 1 2 -- .3 . 4' S Notes: 1). Tests to be repeated at same depth un _il approx = -a telv equal so- .L rates are ob- tained a.t each percolation test hole. all data to be submitted for.revieu. 2) Depth measure-:ents to be made from top of hole. 3 4 - S 1 2 -- .3 . 4' S Notes: 1). Tests to be repeated at same depth un _il approx = -a telv equal so- .L rates are ob- tained a.t each percolation test hole. all data to be submitted for.revieu. 2) Depth measure-:ents to be made from top of hole. TEST. Pi. T DATA REQUIRED 70 E S',B ITTED :I1`H ?PPLICATION DESCRIPTION OF SOILS E Ci:` TEE .RED I'•: TEST HOLES DEPTH HOLE. NO. A_ .HOLE NO HOLE NO. G.L. 6,t TOPS ©4 i_ or 12i:.,f2o w.Q I V L dA . 2 4'' 30" �P-RC 7F- Zaw 36't � Lo t, 42" % S t-') — S 4! t 6 B'' 72 A,DD T- 16 U. 78 " v� F S A fJ D 5 %6 k t 8.4. ;—z- N"s ` INDICATE LEVEL AT 6. -iICH GROUND WATER IS ENCOUNTERED - not encountered INDICATE LEVEL TO WHICH WATER LEVEL RIS =S. AFTER BEI?:G ENCOUNTERED ° n/a TESTS * LADE BY Deep Hole . Auk lE APM, & I'T ✓ . Date August 7 8, 1972 Percolation Au, 17 APM llLa_ Soil. Rate Used 0 °5 _ Min/1" Drop: 125x2 S.D. U's -Ie Area °ro-. ided 250 S. F. No , of 5edroc. -.s 2 Sep i c T Cap, i ty 750 Gals.- Typ` 19oncreie Absorption Area Provided E }7 .84 L. F.:c2' ' 36.1 of; ench. Othcr 1':_rm�yFirtp barn d- weekend retreat, not intend y s full-ti dwellin Name Arthur P. McLau hlin Sic aZre *1 Address yilltovm Road, RD " 5.- z LU Brewster. New ,York 10509 \-Z, �. sa,'�� ? F PUTNA'M COUNTY DEPART*LLrNT. OF HEALTH oFFS`i�NP Soil Pate Approved Sq. Ft. /Gal. Checked h-.r �_ Date "AY-61-42 11161 Am *OWN or PATTURSON P.01 PYINAM COUNTY 04TH WARTMWr D"IM at pMRON)=M.SMALTH URVM. Id St M U)CATION' OWNER'S -NAMOB dewok dfiidkdOe Seen* YHONE MAIM ADDRESS DAZE 'TYtS PERSO NMvmwo FA=" IPROPOSID NSTAUU Tff�p - ADDRLSA NOTE: RqWr mum be In mm WcWft ad dumtW,u o4W wwV &poW q*m DOWO Wadu I u 7T-2- or fislift—A —LA&� mq- MOM rAmad O—tpopow- fivia Ualow loud. a HIM— A id, o..� V.400, 140.,w 'low is *WWI crow V. "AMmaw at. WON on to tw a=&= ftw as do Ibm 1. Aroauc®aat 2. SUbods" of b& L tan" Of InAlHod P" 04A". OMM). ' 9n. Switwomil;i� lid% d. Cal=Ww#fttwk'ftw pwo 6 diem. Xf deep ow commam Is 8*0= lk Tide WUO VCM, Ifebw from 30, ftk(WIMO A I .. - _- '• "P _� _ -- � _ice � - � � - - - I _ � r _ - -- - K _ _ -• _, - _ � �- `j0 ,.,�y,�- - . • ' .;n�aM�R'r�a SRN • �a' �w!�� - .• _ . Orr t CZ amm!mom) room - ` , �f'irlr�'!.�� - r _ _ _ - .. L�OTR�•M/��O.y �.'R f e!'f�f1�� • { �. i�L OT - PL` �1 N �= --.- u►rraA�a :....►...... t i STEVEN SALATINO Landscapes & Renovations 121 EAST HICKORY BEND CARMEL, NY 10512 (914) 228 -4305 DATE 1>i_ SOLD TO: DELIVER TO: ADDRESS: Oo ADDRESS: CITY: Gam✓ PHONE NO. CITY: PHONE NO. a w MAKE CHECKS PAYABLE TO: STEVEN SALATINO • I l 1 A 1 1 1 1 1 1 1 1 A 1 1 1 1 1 1' 1 1 1 1 1 1 1 1 1 7I y "b BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278.6558 WIC (845)278-6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLY) STREET �'� b l�� I b L( TOWN a MAPg NAME of L, G C PHONdj 5 5�0 --�,U PCID9 MAILING ADDRESS DESCRIPTION OF ADDITION 105-0 (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 Road, 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 X. 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 Feb98 BFhouseguidelines BRUCE R. FOLEY Public Health Director LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services 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 (845) 278 - 6014 Preschool (845) 278-6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 LI 6 0 -1-- [ i r Re: 1 l h Residence Tax Map Town 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 This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER Building Inspector BFhouseguidelines FROM OSAMU FAX NO. 7184996417 Feb. 13 2002 12:58AM P4 \ R jI I• I 16 EIH I N II t JJ l LL- O LL- cc �; to as FROM : OSAMU PAX N0. 7184996417 Is ............. ............ jo-l%W Feb. 13 2002 12:59AM P5 0 0 LL- N T7 L! Lo V) 14co Lij I — Now ExtenmorL ar-- - -- r r ,r r,• f— n•-e- �r fe fi- Mudro;orm / Storage :11 FAA. dub rourr► j' i I I j Exist. library Stu it Ij I CI. t! �_ !i Studro Exist. ExTsi.dar Md..... r I , i _--- -- -_____ � =_ ----- ___- - - - -_- _---- -___= _ - - - -- =� =Z: --J� I; Proposed Ground Flaor Plan Feb-- 12' - -02 I' i 0 3 0 0 D 3 C D x m A l0 tD A fD >f N W N m ro N Ul D 3 N i WFddf Exis.,1F3lon I Proposed 1 �Slf�1 f��p Second Floor Plan Feb- 12=-02 0 3 O M D 3 C TI D X O co A t0 1D A r f0 W N C9 CD N RJ i D 3 W t4 is! X CIO t-4 \J FRT SM -BARN 2-4-.4- F T- z BL-vROam) PLOT PLAN SC A, L '10' lj� CIA- House, cowaEcriok) A,S R�q kj i PF.b El - (D- PF Roo L AT ION TEST 40 U�. fj E ,7 P.,P= SITE LOCATION OWNER'S NAME MAILING ADDRESS PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES n 1 O i+ PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OFFICIAL USE ONLY R '00 - 0 Z.. PERSON INTERVIEWED PCHD Complaint # Name & Relationship i.e., owner, tenant, etc. DATE _31 L`L ©'� TYPE FACILITY PROPOSED INSTALLER ADDRESS 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. ;0— J13 I, as owner, r ported en f ee to the conditions stated on this form. SIGNATURE TITLE DATE— Proposal approved a fo llowin c ti s: 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 corners). d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep e. Installers' name and number. 3. System repair to be performed in accordance with the above proposal and conditions. Proposal approved o� Inspector's Signature & Title DATE COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML SHERLITA AMLER, MD, MS; FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health January 26, 2006 Siena Contracting Inc. Jim McGillicuddy 77 Mills Road North Salem, NY 10560 Dear Mr. McGillicuddy: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: Addition — Stillwell 480 Route 164 (T) Patterson, T.M. 24. -1 -59 ROBERT J. BONDI County Executive I have received and reviewed the plans for the proposed addition at 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 three. The potential bedroom count of your proposed addition is five. 2. The addition of a potential bedrooms requires this Department's approval of a revised septic system plan from a professional engineer. Please revise the proposed floor plan to reflect no more than three potential bedrooms, or have a professional engineer or registered architect design a sub - surface sewage treatment system meeting present code requirements for five bedrooms. If you have any questions, please contact me at your convenience. GDR:cw Sincerely, e, Gene D. Reed Environmental Health 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 In tervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 r. SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive DEPARTMENT OF HEALTH fJ 1 Geneva Road, Brewster, New York 10509 Ale. o ADDITION APPLICATION RESIDENTIAL ONLY STREET .! &� -� / / I PHONE J /f?7 GT �G�S �9O'oo2�j MAIL . G q - 1-1 -06 ADDRESS DESCRIPTION OF ADDITION f la )02 NUMBER OF EXISTING BEDROOMS_-3_PROPOSED # OF BEDROOMS —0 (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 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 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 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count ROBERT J. BONDI County Executive Re: (Owner's Name) Tak7Map #: c�2� Address: 5�&d /1v V' Town: Year Built: % go -,2 According to records maintained by the Town, the above noted dwelling, is in compliance with Town Code. is not in compliance with Town Code. The Legal Bedroom Count is: This information has been obtained from: Certificate of Occupancy: Other: A.47f- Building InsjectW Date Environmental Health (845) 278 -6130 Fax (845) 278 -7921 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 ' a SITE LOCATION I /cy TM# OWNER'S NAME PHONE MAILING ADDRESS PERSON INTERVIEWED v�:a- '�""�''%� PCHD Complaint # . Naxne.& Relationship i.e., .owner; tenant, etc.) ,n DATE .TYPE FACILITY 44C ,ss ,��� / ✓� PROPOSED INSTALLER PHONE i . ADDRESS. REGISTRATION #:`: o sa' (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. -' -fir �C� r r t7�'I►su� Lam/ f .�.. .'' / �� svdc _T` �'f ` ��� .�! A(_5 :`' �::-, CL c��o .0 duo .E°' r ;s %'r � � /� � =e:- • �; ..- _.__ .. . I, as ownet, or reported ag , nt of owner agree:toAhe conditions stated on this.,form. . f SIGNATURE .TITLE DATE Proposal approved with the following conditions: L 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 iristahed components tied to two fixed points (e.g.,house comers). d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X. 6' deep e.. Installers name and number.. 3. System repair to be performed in accordance with the above proposal.and conditions. . Proposal approved Inspector's Signature & Title COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML ATE 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 (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 April 24, 2002 Molu LLC 77 Mills Rd. North Salem, NY 10560 Re: Addition - Molu LLC, 460 Rt. 164 (T)Patterson, TM #24 -1 -59 Dear Applicant: I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans indicate-that the proposed addition will consist of the following: A new mudroom, studio, master bedroom suite and increased bedroom size. Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: . 1. A survey showing well and septic locations has not been submitted. 2. The studio is considered a potential bedroom. 3. The legal bedroom count for the dwelling is two . The potential bedroom count of the dwelling with your proposed addition is three 4. The addition of a potential bedroom requires this Department's approval of a revised septic system plan from a professional engineer. Please revise 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. If you have any questions, please contact me at your convenience. ML:lm Very truly y urs, Michael Luke Public Health Technician HOUSE CONNECT CONVERTED 7BARN AS 24-. X 4 FT Z BE7>ROOP-4) APPROVEC PS, :OLATh, TCTEST T 40 10 LIE , IIIG2 117 IG2 A L 1972 mi u'A D -T-IGH-r� PIP-E PUTN u Of, HEALTH OR -S RA; PLOT PLAN DIVISION OF Sr- A, L f-: 10, VMRONMENTAL HEALTH S.MVUl i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or type PCHD Permit # Well Location: Street Address: Town/Village Tax Grid # 480 Route 164 Patterson Map 24 Block 1 Lot(s) 59 Well Owner: Name: Address: Siena Contracting 77 Mills Road, NorthSalem, NY10560 Use of Well: X Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary _ _ _._ Industrial Institutional Standby Amount of Use Yield Sought" 5- 10"-gpiry #-People-Served -- ---- -Est.-of Daily-U- sage-_L- ._gal. __. Reason for X Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason Shares well wit eighbor for Drilling Well Type X 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: P.F. Beal & Sons, Inc. Address: 4 Putnam Ave. , Brewster. 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 provided on eparate sheet/plan. Date: 9/-14/04..-.,- Applicant Signature: _.. _..__� ._.._.. Phi i J Beal 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. APPROVED. FOR 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. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a wate driller ce ifed by ut am County. Date of Issue 10/1 ° Permit Iss ' cial: V L)6��' /Ao� Date of Expiration i- o Title: Permit is Non White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 J acknowledge receipt of this report SIGNATURE; ,02/96 :'Title. 10/05/04 TUE 09::30 FAX 1 a o �+ 5 D5 �`l 1 IM 002 • j a v OF P. 2 Page 1 of 1 FreeB,nce PRINTOUT TITLE I Philipstown Road Names Putnam Valley Road Names b � =t.n .�. �' " s } �� t�?3L�t =in: ,S'o _i - e {X�i�,'�'r *7 � "• --�� .,� .�j ;. ��-•�, '.:t 4 ti ,f >.'�SL • '�4 �rt�♦ -�, ♦ :a ".c t ♦ i•. ♦ • `..t,1• w7,i •. t.:�. ♦ �4• ♦t }� � ;`�'�r • '�. • ♦ �, > • ti t l':r . � i�:'•' �'��' t�. .�i ..1 ry ;1ii` iu t °� ",•1, .: •, ,3•h.•. l "d[�:;•• 1?S� .,: i `~.. i1 M1:� grin• i �] 'Tf �� , "?'' L�'��3� �^ )� x� ;��`•ii�����.s f! ".•• . '' h� %+- !•'i,C�i��d�,�������a3°.L�,i - -..ii �l•izia ii. � ..�i- S:S�::iu:�._::i3'_�.,..... •F /�dr =� 1•': A�4 _ '?:•z:.z1 '•��`�_l:•�� -' - -:r ti r. — - CERTIFICATE OF OCCUPANCY AND COMPLIANCE Tia�jn VIA.. , of Pilersort, Aefu M 11 20 03 r 1' :s DATE ISSUED Novelnfe� T Q, ro. f THIS IS TQ -CERTIFY THAT MOLD, LLC w ON THE PROPERTY QF Sam ' I . LOCATED ON 480 Ro•tac 164.. m' 1 Ir S BEEN SUBSTANTIALLY CONSTRUCTED TG THE REQUIREMENTS OF = THE BUILDING CODE-; ZONING ORDINANCE AND LOCAL LAWS ORTHE; OWN 3' ;' OF 1'ATTERSDN, NEW YORK AND MAYBE OCCUPIED AND USED AS o ) Move. F►cvnt Doo4 6 I:ntAarge Pohch 1 1"taU intQAiOA S•taiAcaae C ( ' Z o Building Permit Dated .5 ;a :o2„ PGTMR fro.. .1.... Appkation No. _Jg63.,,,. F 1 - SECTION ...... ..? :............ BLOCK ........ ............... LOT....... 9.._....._.. W f 3 it BUILD19d INSPECTOR �•tF177r�A•it14"�.�53+-7 .�'/Df:IV• ":I� �vRiL� •'( 'nC "f+•`]2L!_i:TJfil!):�R'f�l'' S3_ A � Y�i3YLi�!Rr IA�S� "Y.l' -f tii' S.' 4{- 1�: 1' t' S¢ iCP�I )iTRiil�)113�5'�,�/li)�.i�lii� Y 61 L� I A) a 0 w P.F. BEAL & SONS, INC. 4 PUTNAM AVENUE ARTESIAN WELLS BREWSTER, NEW YORK 10509 WATER TANKS WATER SYSTEMS COMMERCIAL WATER SYSTEMS JET PUMPS �ula6f riieo�lB9! - �uef /3, 2!S 79)eiis Comole %d HYDROFRACTURING SUBMERSIBLE PUMPS TEL. (845) 279 -2460 - 2461 WATER CONDITIONING EQUIPMENT FAX (845) 279 -6613 i COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERIVICE 480 Route 164 Patterson, NY Tax Grid #24 -1 -59 �pJi�'1 �p•P n 1 a 3 t1V 1 A \`yam • \ 1034 TLB 09:30 FAX ARTESIAN WELLS WATER SYSTEMS JET PUMPS SUBMERSIBLE PUMPS I P.F. BEAL & BUNS, INC. 4 PUTNAM AVENUE EIREWSTER, NEW YORK 10509 A444"%(lm — Owlt /r4 ?0 mac. pled TEL. 279.2460 - Z461 FAX 279.6613 COMPLETE INSTALLATION, R6PLACEMENi AND REPAIR SERIVICE FAX TRANSMITTAL SHEET DATE: )O�% TIME: % D. Q0 TO : act C Ian ) e V, COMPANY: ` FAX PHONE NO: 9a, I FROM: eC� TELEPHONE NO: JOB REFERENCE MESSAGE.* 5 1 ? .1a C G n t G C_?�_i_!��___ NUMBER OF PAGES INCLUDING TRANSMITTAL; 3 0001 WATER TANKS COMMERCIAL WATER SYSTEMS NYDROFRACTURING WATER CONDITIONING EQUIPMENT ICA.= • PI ITMOM rnI IKITv nFPAPTMPWT nF P. 1 LORETTA MOLINARI Public Health Director 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 P.F. Beal & Sons, Inc. c o Philip Beal 4 Putnam Avenue Brewster, NY 10509 September 16, 2004 Re: Proposed Well: Siena Contracting 480 Route 164 (1) Patterson Dear Mr. Beal, ROBERT J. BONDI County Executive I have received a well permit application (WP -97) and a certified check in the amount of $150.00 for the above referenced proposed well. Comments are offered as follows: 1. Please contact the Town Building Department and obtain a letter verifying that both residences at the subject parcel are approved dwellings. 1. Dimension the location of the proposed well from two fixed points. If there are any questions please contact me at (845) 278 -6130 ext. 2235. Upon receipt of information addressing the above noted comments, this application will be considered further. Very truly yours, Brian R. Stevens Public Health Technician cc: RM,file P. F. BEAL & SONS, INC. 62063 ARTESIAN WELLS -,.PUMPING EQUIPMENT WATER CONDITIONING EQUIPMENT BREWSTER, NY 10509 ` N:M768 DATE �- �S 7 PAY TO THE$"..°"" ORDER OF �%n A Cs9E L J= D/ O DOLLARS BROF v NEW 700CW&Tb�C�onjErrn -(wY AL YORK ate., NY iosog lrlE'J11ig Lip, nwv 118062063110+40219023S24 11'00 ?8 20 2 3 ?8110 SITE LOCATION OWNER'S NAME _ MAILING ADDRESS PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR Y OFFICIAL USE ONLY Q -oz,- TM# ;, cel— f , PHONE PERSON INTERVIEWED e---, PCHD Complaint # ame & Relationship i.e., owner, tenant, etc.) DATE TYPE FACILITY PROPOSED INSTALLERS PHONE ADDRESS ° ��� �' �'''� Ac /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. v T-7 I. &vo her, or reported agent of owner agree to the conditions, stated on this form. SIGNATURE TITLE DATE Pro op sal 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 corners). d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep e. Installers' name and number. 3. System repair to be performed in accordance with the above proposal and conditions. Proposal approved J Inspector's Signature & Title ATE COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner. Address t Located at (Street) Tax Map a- f(, Block Lot (indicate nearest cross street) Municipality Watershed A�ws r, ?37gAkgt+ SOIL PERCOLATION TEST DATA Date of Pre = soaking 5- 1106 Date of Percolation Test '5' .2. 0 6 ...... .... ........ ............ .. ......... . .. .. .41 Xom. G 'ou a. ... ... .. ....... ...... Time:: ::r urfAce; ile- e start S- t art:: -: 2 7 2- -7 3 o-, 2-1- / Vy 4 !3-7:-;j,.',16 2-7 3 3 3 3 10 4 8 — 3: V 0 3 — Al -16Yf /;L J; 5 '.;70- Y'02-0 3, Yy 2 6!I',Il, 2 3 4 5 LUTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I 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 I 3a s:2y 31 DEPTH G.L. 0.5' 1.0' 1.5' 2.0' 2.51 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' ...TEST PIT,DATA : 2 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. HOLE NO. 7. G -7. Indicate level at which groundwater is encountered Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: Date :; t p� Design Professional Name: Address: Signature:. Design Professional's Seal 'PUTNAM COUNTY DEPARTMENT OF HEALTH Y DIVISION OF ENVIRONMENTAL HEALTH. SERVICES INITIAL. INDIVIDUAL /COMMERCIA•L SITE INSPECTION FORM 'SECTION A.: GENERAL INFORMATION Name of Project 575iyA1oz/ --&V) Rmx- a ) County RU r X:)AV Site16cation gki // Building'construction-begun Extent A -4o -S , Is roP e rty w .ithin NYC Watershed ? ................. Yes No P SECTION B. TOPOGRAPHY (Please check all appropri "boxes) 1. F_� Illy. ;[7 Rolling 0 Steep slope Gent e;slope O -Flat 2. Evidence of wet ands , . Low area subject to flooding . s«je`�10. ��1041 a Bodies of water � -� ovar�(a:.,� 7e�•�- v��l'etl a Bra gL e'2 i c'ies F7 Rock outcrops 3. Property lines or corners evident .....::....:....:.:..:. ............................ .... 'des "No 4. Do water courses exist on or adjoin the property? �%�Q b LiaJs�' J ............... Yes No 5. Will these affect the design of the sewage system facilities ?............ Yes - No 6. Do watershed regulations apply in this development ?..............:... ...... Yes'. F7- No 7 Will.extensive grading be n . ecessary .. � � ................. ............................... Yes No 8. Will extensivefill be-mc'essarq for SSTS? ......... ........................... ..... yes, No' .9. . 9. Do filled areas exist within the SSTS area ? ......................................... Yes dNo. If yes, what..s the condition of the fill? SECTION C: SOIL OBSERVATIONS l 10. Appearance of soil: F7- Sand a Gravel Loam 0 Clay . 0 Hardpan 7 Mixture 11. Observed from: F-] Borings a Bank cut D Backhoe excavations 12. Soil borings /excavations observed by �. !�� ( on 13. Depth to groundwater on 14. Depth to mottling %i on 15. Are test holes representative of primary & reserve areas ...... ................ ......:......... 16. Soil percolation tests made by 31"g. Aez,dG,c on 17. Soil percolation tests witnessed by on , SECTION D (on back) 51 Form ST -1 ! 24. Site observer /inspector.and title �Pkez jl, 25. Date(s)- of observation (s)inspection(s ) �,2 /a( 2 TEST PIT PROFILES Hole # Lot # SECTION D. DRAINAGE Hole # Lot # Depth to water 18. Will proposed grading materially alter the natuiral "drainage in this or adjacent areas? F Yes io 19. Will groundwater or surface drainage require special consideration? ..................... a' Yes No 20. Will gullies, ditches, etc,, be filled and watercourses be relocated ?..... .. ................... a Yes o SECTION E. REMARKS s 21. If a common water supply is proposed; ,has an inspection been made of the 0.5 1.0 existing or proposed source and facilities? ................................ ............................... L7 Yes ' [ o 2:0 Inspection data 3.0' 3.0 22. 4.0-1- 4.0 Do adjacent wells and/or sewage systems exist? ...............::.... ............................... Yes .No 5.0 23. Additional comments 6.0 6.0 24. Site observer /inspector.and title �Pkez jl, 25. Date(s)- of observation (s)inspection(s ) �,2 /a( TEST PIT PROFILES Hole # Lot # Hole # 'Lot # Hole # Lot # Depth to water Depth to water Depth to water Depth to mottling Depth to mottling Depth to .mottling Depth to rock/imp. Depth to rock/imp.. Depth to rock/imp. G.L. G.L. G.L. - s 0.5 .0.5 0.5 1.0 1.0 1.0 2.0 2:0 2.0 3.0' 3.0 3.0 4.0-1- 4.0 4.0 5.0 5.0 5.0 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 Street Town ... ,State :Zip PERSON IN CHARGE L1R M, TTFR VT - � PAX7P - / nw .0l.AA C S dr Tla4a • . 6 a. SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF. HEALTH 1 Geneva Road, Brewster, New York 10509 REQUEST FOR FIELD TESTING All information below must be fully completed prior to any scheduling. ROBERT J. BONDI County Executive DATE: 41-12-06 ENGINEERING FIRM: ,t 1dr-gY Z63R %7 iGS PHONE #: .S S- � PERSON TO CONTACT: /� ►G/-rm0�/Tf��A/� ❑ NEW CONSTRUCTION ❑ REPAIR PROGRAM XADDITION PROGRAM REASON: DEEPS:A- PERCS: AL PUMP TEST: ❑ ROAD /STREET: lQovTI za TOWN: f� -TTi= 2Sor� SUBDIVISION: OWNER: �oSrPl S� /L �✓l �-c- TAX MAP #: 2"1 -- / — S% LOT #: NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING . YES NO o Proposed SSTS within the drainage basin of West Branch or Boyds Corner & - --Croton-Falls Reservoirs. - ❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake. ❑ Pg- 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. ❑ pL 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 yes 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 NYCCEP. 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. FOR COUNTY USE ONLY DATE: h 73 dnCP TIME: COMMENTS: REQ. FOR FIELD TES7MG:KLV 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 (843) 278 -6026 WIC.(845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 A24 s z; d 4 0 «, N I 0 ji x'51 SS, *k 1 V 1 CONSTRUCTION NOTES FOR 8.8.T.& 8 WELL. 1 ALL TREES WITHIN 10 FEET OF THE PROPOSED SUBSURFACE SEWAGE -,____ TREATMENT 8YSTEM (33T3) SHALL BE REMOVED. 14.164 (2/87) —Text 12 PROJECT I.D. NUMBER 617.21 Appendix C State Environmental Quality Review SHORT. ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only 'PART 1— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEAR 1. APPLICANT /SPONSOR 2. PROJECT NAME 3. PROJECT LOCATION: • • Municipality �A 7 E ZS p N County ?,.rryV A 4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map) 5. IS PROPOSED ACTION: ❑ New ❑ Expansion ❑ Modification /alteration 6. DESCRIBE PROJECT BRIEFLY: AGAO.rOc,N OLD 3 F SDfr_aoAA ssTS P2a�es,trC,� 3 Bo;Dazoo+l�1 +�1DDtT;�oN, ANC7 /u �1� �,x 8�Dr2oor✓j 7. AMOUNT OF LAND AFFECTED: Initially • acres Ultimately • acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? 21es ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? 91residentiai ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/Forest/Open space ❑ Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL),? -, [3 9 Yes No If yes, list agency(s) and permitlapprovals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAL16 PERMIT OR APPROVAL? ❑ Yes C3'90 if yes, list agency name and permlUapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? 1-1 Yes t� No I CERTIFY. THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE �, S T .� t c, ,_, Apptica sponsor •name: Dale: Sign re: If the action Is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment. O:VER 1 SDA PART 11-- ENVIRONMENTAL ASSESSMENT (To be completed by agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.121 If yes, coordinate the review process and use the FULL EAF. ❑ Yes o B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another Involved agency. ❑ Yes No C. COULD ACTION hESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, If legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: / VQ C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: AJV , C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: do C4. A community's existing plans or goals as officially adopted, or a change in use or Intensity of use of land or other natural resources? Explain briefly C5. Growth, subsequent development, or. related activities likely to be Induced.by the proposed action? Explain briefly. AID C6. Long term, short term, cumulative, or other effects not Identified In Cl- C51,Explain briefly. C7. Other Impacts (including changes In use of either quantity or type of energy)? Explain briefly. A'(b - D. IS THERE, OR I�TERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL El Yes o If Yes, explaln briefly T PART III — DETERMINATION OF SIGNIFICANCE (ro be completed by Agency) INSTRUCTIONS: For each adverse effect Identified above, determine whether It Is substantial, large, important or otherwise significant. Each effect should be assessed In connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) Irreversibility; (e) geographic scope; and (0 magnitude. If necessary, add attachments or reference.supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been identified and adequately addressed. ❑ Check this box If you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare, a' positive declaration. TCheck this box If you have determined, based on the Information and analysis above and any supporting documentation, that the proposed action WILL NOT result In any significant adverse environmental Impacts AND provide on attachments as necessary, the reasons supporting this determination: Print or TVDe Name%ot Resoonsi le n ir in I o: :er in Lead Agency Signature of Preparer (if different from responsible officer) r2 0 Date K ,SSOCIATES, L.L.P. eers - Planners Putnam County Department Of Health 1 Geneva Road Brewster, N.Y. 10509 ATTN: Mike Budzinski RE: Stilwell Residence Route 164 Patterson Dear Mr. Budzinski: June 20, 2006 Joseph J. Buschynski, P.E. Timothy S. Allen, P.E. Sabri Barisser, P.E. John P. McNamara. P.E. Robert A. B: Howe. B.S.. Phys. Enclosed please find 4- copies of the revised Stilwell Septic Plan, as well as 4 copies of the Profiles & Details. Per your comments we offer the following: 1. The PVC pipe from the tanks to the distribution box is now shown on the plan and profile, with a rating of SDR -35. 2. The absorption trench detail is now revised to show the pipe being installed level for..a dosed system. 3. The absorption trench detail is now revised to show the minimum separation distances to groundwater'and ledge rock. We look forward to receiving your approval. MJG /mg Enclosures Very truly yours, Matthew J. Gironda. Planning . Site Design . Environmental Mill Pond Offices 293 Route 100. Suite 203 • Somers, NY 10589 Phone: 914- 277 -5805 Fax: 914- 277 -8210 • E -Mail: bibbo ®optonline.net SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Matt Gironda Bibbo Associates Mill Pond Offices 293 Route 100, Suite 203 Somers, New York 10589 Dear Mr. Gironda: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 July 5, 2006 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Proposed SSTS for Stilwell NYS Route 164 (T) Patterson, TM# 24 -1 -59 This Department has received and reviewed the submitted application and plans for the above referenced project and the following comments are offered for your consideration. w"11. The PVC pipe from the tankage to the distribution box is to have a minimum rating of SDR -35. A-1. _ .The_absorption trench detail is to be revised to specify the perforated pipe as being level */� for a dosed system. 3. The absorption trench detail shall specify a 5 foot minimum separation distance from the bottom of trench to ledge rock and a 4 foot separation distance to groundwater. Upon completion of the above, this Department will continue its review. Kindly advise us if there are any questions. MJB:cj Michael J. Director of 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 Matt Gironda Bibbo Associates Mill Pond Offices 239 Route 100, Suite 203 Somers, NY 10589 Dear Mr. Gironda: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 June 30, 2006 1/ Re: Proposed SSTS for Stillwell 480 Route 164 (T) Patterson, TM # 24 -1 -59 East Branch Reservoir Basin ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health The Putnam County Department of Health (Department) has determined that the above referenced application, including fee, and received by this Department on June 29, 2006 is complete. The Department will notify you by July 20, 2006 of its determination. IK The Project has been delegated to the Putnam County Health Department for review to the guidelines set forth in the Watershed Agreement. ❑ Joint review with the NYCDEP will commence pursuant to the guidelines set forth in the Watershed Agreement. If the Department fails to notify you within the above referenced time frame, you may notify the Department of its failure by certified mail, return receipt requested. The notice should be sent to my attention at the above address. This notice must include your name, the location of the project, the off oe- with-which you filed the application originally, and the statement that a decision is sought in accordance with section 18 -23 (d) (6) of the NYC Department of Environmental Protection Watershed Rules and Regulations. If the Department fails to notify you within 10 days of the receipt of notice, your application will be deemed approved, subject to standard terms and condition as set forth in the regulations. Please be advised that projects within the NYC Watershed may also require Dept. of Environmental Protection review and approval of other aspects of a project, such as storm water plans or the creation of impervious surfaces, and the project applicant should contact the Department of Environmental Protection regarding such activities to see if Department of Environmental Protection review and approval is required. If you have any questions regarding this matter, please call me at (845) 278 -6130 ext. 2148. Respectfully, 1 Bu ns Director of En ineenn MJB:mcb 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 i BRUCE R. FOLEY Public Health Director TO: 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 'SISSY b 1A Q-S�- DEPARTMENT OF ENGINEERING AND DESIGN REVIEW DELEGATION STATUS FOR SUBSURFACE SEWAGE TREATMENT SYSTEM PROGRAM DELEGA TED PROJECT: 'S j11-\ A) F U L- TOWN:. C SE AK PV_ _ DATE SUB'D APPROVAL: NOTICE OF COMPLETE APPLICATION DATE: 0 `�' BIBBO ASSOCIATES, LLfP TO: R) T#J A M 6 —,V "#9Uri+ D6 Pr DATE: � Z I /06- C �NEV✓� 2� RE: ��NSitFL Its . `l. 41 SO Eovi-e— 16 li P --r tz S o /v !Oral WE ARE SENDING YOU (,'ATTACHED ( ) UNDER SEPARATE COVER THE FOLLOWING ITEMS VIA # COPIES DESCRIPTION SSDS PC. DJ SOS PLAN)., � ?2vF1c.ESZ DG tl- �i J �. S iiOfi -1 olziv\ i- Gnt -�Si uc loon ?F i> A��S D�E�S G N D '-A S HGC� -'S �>ZoNT fi c. I Ac.2JvV0o THESE ARE TRANSMITTED AS CHECKED BELOW: ( FOR YOUR APPROVAL ( ) AS REQUESTED ( ) FOR YOUR USE ( ) FOR REVIEW AND COMMENT REMARKS: COPY TO: SIGNED: 293 ROUTE 100 — SUITE 203 SOMERS, NY 10589 (914) 277 -5805 — (914) 277 -8210 FAX — bibbo @optonline.net IF ENCLOSURESARE NOT AS NOTED, laNDL YNOTIFY USA T ONCEAT (914) 277 -5805 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner j msr?rl . STi L1-0& L Address Z L. sCoADWA1j NC;.,,, Yor.►c N.Y, i000 y Located at (Street) `Igo 20 vis t6-( Tax Map 211 Block / Lot 159. (indicate nearest cross street) Municipality FpyiTs2sooa Drainage Basin EAsr r3riAtvc.� -1 .2c5EZ�o,2 SOIL PERCOLATION TEST DATA Date of.Pre- soaking Date of Percolation Test. Hole No. Run No. Time Start - Stop Ela se Time (pMin.) De th to Water From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch I 1 1 5� - 2:►6 Z Z 31 39" 3 " 7• SS 2 29 3 Z'.`Il:, - :16 30 3o3''�r� 3 s� l O 4 .1$ ' : `-18" i; 0 •._ . 30 5 3'So - (4 S o 30 3/y„ 3 3'44 • 2 1 I .5 -1- L: z Z y o" S31 A " _._....�... 2 2: ZZ - Z:3y 30 , 33„ 3 30" 4 Z .y � - 2: S6 � o„ 3 3" 3 5 1 2 3. 4 ,5 , NOTES: 1.• Tests to be repeated at same depth until approximately equal percolation rates are obtainers 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 DEPTH O.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' 2 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES HOLE NO. HOLE NO. Z HOLE NO. It '' M, 8 Indicate level at which groundwater is encountered 1 z, Indicate level at which mottling is observed Wt Mor % Lio Indicate level to which water level rises after being encountered .. Deep hole observations made by: 7, ,g,3„ A�6So L, w 45 6 ,g- eiagepSDate Design Professional Name:. Address: BIBBO ASSOCIATES LLP __ 0 NEW ip� 734 � Design Professional's Seal PUTNAM COUNTY DEPARTMENT OF HEALTH. DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER TREATMENT SYSTEM _ 1. Name and address of applicant: �o s �►� Sr , w 2 6 Q ►zo ADw P J "F-y Yo rz. k N.Y. /0 00 2. Name of project: 5T 7 Z- w S c- t_ 3. Location TN: E+-TT-F'2 Sa.J 4. Design Professional: g, gg, r46.so &,g i5z S 5. Address: y f0 9-1 s 16 y .6. Drainage Basin: _rRsr— &gg &)cN Rzc_sEZV0 <- FAITg:msopo , ICJ- Y-7. Type of Project: ✓Private/Residential Food Service Commercial Apartments Institutional Mobile Home Park, Office Building Realty Subdivision Other (specify) 8. Is this project subject to State Environmental Quality Review (SEQR)? Type Status (check one) ....................... ..............:................ Type I Exempt Type II Unlisted 9. Is a Draft Environmental Impact Statement (DEIS) required? ......................... N . A . 10. Has DEIS been completed and found acceptable by Lead Agency? ............... 1J . A. 11. Name of Lead Agency L. 14. D. 12. Is this project in an area under the control of local planning, zoning, 'or other officials;- ordinances? ....................... ............................... ...... ............... ......... o 13. If so, have plans been submitted to such authorities? .:...... ............................... 14. Has preliminary approval been granted by such authorities? Date granted: P J . A . 15. Type of Sewage Treatment System Discharge ................. surface water ✓groundwater 16. If surface water discharge, what is the stream class designation? .................... ".A. 17. Waters index number (surface) ......................................... ...................... .....:.... 18. Is project located near a public water supply system? ....... ............................... tV a 19. If yes, name of water supply. �U . A . Distance to water supply AJ. Iq 20. Is project site near a public sewage collection or treatment system? ................ iV o 21. Name of sewage system IU . (� Distance to sewage system J�A 22. Date test holes observed . S /z / o 23. Name of Health Inspector („ EN r— 2EED 24. Project design flow (gallons per day) .. .. .............. 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... �J o 26. Has SPDES Application been submitted to local DEC office? ......................... Fnrm PC -97 2 27. Is any portion of this project located within a designated Town or State wetland? ` S 28. Wetlands ID Number ........................................................... ............................... 29. Is Wetlands Permit required? ......................................:....... ... ............................. 9101 Has application been made to Town. or Local DEC office? ............................... 30. Does project require a DEC Stream Disturbance Permit? .. ............................... k) 3.1. Is or was project site used for agricultural activity. involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landflling; sludge application or industrial activity? ......... ............ ......... Yes/No u 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous, wastes-ite, salt stockpile, landfill,` sludge disposal�site or any other potentially known source of contamination? ............................... Yes/No A) a DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... y s 34. Are community water and/or sewer facilities planned to be developed within 15 years in or adjacent to project site ? ........... : ................................................... /J 35. Are any sewage treatment areas in excess of 15% slope? . ............................... 00 36. Tax -Map ID Number .......................................................... Map_Z l-! Block I Lot 37. Approved plans are to be returned to ..... Applicant l/ Design Professional NOTE:. All applications for review and approval of anew SSTS to be located within the NYC Watershed shall be sent to the Department, and need not be sent in duplicate to the DEP, although the project may require DEP approval of the SSTS prior to final approval by the Department. Projects within the watershed may also require DEP review and approval of other aspects of a project, such as stormwater,plans or the creation of impervious surfaces, and the project applicant should obtain the appropriate forms for such activities from DEP and submit those forms to DEP for review and approval. If the application is signed by a person other than the applicant shown in Item I .,the application must be accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision . may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury; that to the best of my knowledge and belief. F e . a C1ass.A misdemeanor pursuant to S ction � SIGNATURES & OFFICIAL TITLES Mailin Address :..... .:..........1.................. ation provided on this form is true e is made herein are punishable as of the al Law. MI Route 100 - Sufte 203 - 959 eSO0, -(C4.J I-- PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES LETTER OF AUTHORIZATION RE: Property of Located at 'S5-1– T/V q-i ,, 'i5Z4 o0 Tax Map # ?_ L-1 Block I Lot � R Subdivision of Subdivision Lot # Filed Map # Date Filed Gentlemen: This letter is to authorize a duly licensed Professional Engineer or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Depart to sign all necessary papers on my behalf in connection with this matter and to sup ion of said wastewater treatment and /or water supply systems in conformity w' icle 145 and/or 147 of the Education Law, the Public Heaftl _ Y Law, and �iy ode. Countersigned P.E., RSA., # Mailing Address gIBBO ASSOCIATES LLP 293 Route 900 a Surge 203 Somers, IVY 10588 State Zip Telephone: 2-. 7 - 63 o S; Very truly yours, . Y Signed:- (Owner of Property) Mailing Address: 4 $ 41 � s b�o State U itsI`L<-- Zip Telephone: �� (z� Z (5 - 'S 80 0 Form LA -97 ztll��. 5440 NSJ71W 2a 50' S'y9•S • UL?' w �6 w'6a3o Se? . 141' 60 o• Ihy h PQVO m 0.`,SNEO r Map J1 90 ROVO ° -- t, .S'NEO \\ CARMN AREA or !Q7 II \ �� II \ II I dray., vfs 0 $61.44 Y r NEW nwAl 4 2, 2W2 ' 10, AM A 2002. 1*1-c aR.ulcAnaic / N£RLBY aRl9'Y M Af RAMS a* 0 1 f GY 7av lS A < AAR$ A 1f Af NA1UR1e 6 V.WPYANCY, A'VC 2) AKY!/, LLC F/ECo % 7k ) o `` h J196 J/'+ ''` I S�jSg• b \ \ I SHED 1\ V \ 1 STAPY \ MAMF //a/-V- _....... \ 1 /// ' Il i I A ZONE'' �titi`'y to B. z4 ACRD'S II � I� II� �� II \ II I dray., vfs 0 $61.44 Y r NEW nwAl 4 2, 2W2 ' 10, AM A 2002. 1*1-c aR.ulcAnaic / N£RLBY aRl9'Y M Af RAMS a* 0 1 f GY 7av lS A < AAR$ A 1f Af NA1UR1e 6 V.WPYANCY, A'VC 2) AKY!/, LLC F/ECo % 7k ) o `` h J196 J/'+ ''` I S�jSg• PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES GUARANTEE OF SUBSURFACE SEWAGE TREATMENT SYSTEM Owner or Purchaser of Building ,� C Building Constructed by L�90 1?04/?Y /V/I-/ Location - Street Building Type Tax Map Block Lot A,22 _rZe4 &/Z Town/Village or Subdivision Name Subdivision Lot # I represent that I am wholly and completely responsible for the location,-.workmanship, material, construction and drainage of the sewage treatment system serving the above - described property, and that is has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to the owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of approval of the "Certificate of Construction Compliance" for the sewage treatment system, or any repairs made by me to such system, except where the failure to operate properly is caused by the willful or negligent act of the occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Public Health Director of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated: 'Month ©� Day Yea 4.0 (e) General ontractor (Owner) - Signature Corporation Name (if corporation) Address: Z� 5 L �b } A at State Zip 0 6 6 Signature: Title: Corporation Name (if corporation) Address,: �% Wale State ip 7/� /.# /0. S_ �5_ Form GS -97 BIBSO ASSOCIATES LLP 293 ROUTE 100 - SUITE 203 SOMERS, NY 10589 (914) 277 -5805 _ (9 14) 277 -8210 FAX TO 2 �wSTz 2 /, /US7C) y WE ARE SENDING YOU Attached ❑ Under separate cover via ❑ Shop drawings [4 Prints ❑ Plans ❑ Copy of letter ❑ Change order ❑ DATE gr NO, ATTENTION RE: 5% //A C/ r0 A 7 16 Approved as submitted 4s —dc ❑ For your use ❑ Samples the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION F&LFor approval ❑ Approved as submitted 4s —dc ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections cc,' C_ ` W ❑ For review and comment ❑ 0 FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS THESE ARE TRANSMITTED as checked below: F&LFor approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ 0 FORBIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO / J' SIGNED: If enclosures are not as noted, kindly notify us at once. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OFF ENVIRONMENTAL H + ALTH SERVICES m FINAL SITE INSPECTION :Date: 8� OG Inspected by: .Street Locations 'Town . P��S� ►,.. ' `Permit # Q - aq - ©6 IM4 2, -f, _ - 9 Subdivision Lot 1. 'SewaEre `System :Area .a::STS area located rayed:: Tans .............:. P P P ............ b,. ` Fill�section�= ;date��of,placement 3 l barrier` Lgth. Width. Avg.Dp -t C . N atural soil not ;stripped... :. d. Stone 'b rus h .etc., gre ater, than 15' from STS .,area.......... e. -1:00' fromiwater cour --se/ wetlands.:.... . .... ........... ............. ... II. S.ewag_Oystem. a. Septic tank size - :1,000 ................ 1,250 .............. .other... :b. Septicaank:ii stalled`level. c. `1.0' minimum from: foundation .. ............................... .... d.. Distributio-fi':Box 1 Alr:outlets ataame elevation :water tested: ........... 2..P.rotected below .frost........ ........... 3 Muumum 1_ $:'Original soil between box & trenches. e. .lunation fax properly set ......................................... . 6, renfiies r 1. `Length required -76-6 Length installed 6 2. 'Dift�ance to watercourse measured Ft.......... 3 Installed according to :.plan .... ........... 4 Slope of-trench acceptable 4 -44222 ' ot... Acme,! 5. 10 ft. from roP e rt3 line -. 20:ft:-:foundations.......... P.: '�. 6..Depth of trench <30 driches fromsurface .................. 7..Room.allowed for. expansion, 100 %0 ......... :............... S. Size of.gravel3 /4 112 "diameter clean ...................: 9.. Depth td%gravel :in trench 12" minimum ................... 10 Pipe e�y a ed ............................ ......................... . g.:Pum or sse' terns ,. ,; 1. =Size OYTTE 0 ... . ©..p b ...j'. 2. Overflow tank ................. . . ........................... 3: Alarm, vsual/audio :.::......::. :. 4. Pump :easily. :accessible, manhole to ,grade ................. 5. First.b.ox.ba$ led .......................... ............................... 6. Cycle- witn.essed by H::estimated flow /cycle........... In HousAt dir g a. fiouse'.located .per .approved plans ................... b. . Number of bedrooms ..... ..............................: IV. We11 .............. Well located as per approved plans .......:............ ............ b.. .'Distance from STS area measured ft ........... c. Casing: hg,,.above grade ................ .... ............................ d. Surface drainage around well acceptable ....................... V. Overall Worlunanshin a.. Boxes properly .:grouted ................... b. . All pipes partially baelffilled ........... ............................... c. All pipes flus�h.with'inside of box ... ............................... d.. Backfill material-contains stones <4" diameter ............... e. Curtain drain :& standpipes installed according to plan.. f. .Curtain drain outfall protected & .dir.to exist watercourse g. Footing drains discharge away from STS area ............... h. Surface water protection adequate ....... :.............0............ i. Erosion control provided ................. ............................... Rev. 12/02 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL IiEATLH SERVICES FIELD ACTIVITY REPORT NAMF' Street Town State Zip PERSON IN CHARGE nR TNTRRVTPWFn-. T1atP: Q. E] PUMP TEST DOSE TEST 3" REQUIRED GALLONS Signature.and Title REPORT RF1'FTVFT) RV: I acknowledge receipt dthis report: SIGNATURE: 02/96 Title; Rev. I` p 3" REQUIRED GALLONS Signature.and Title REPORT RF1'FTVFT) RV: I acknowledge receipt dthis report: SIGNATURE: 02/96 Title; Rev. 08121,,06 MON 10:39 TEL 91.4 277 8210 BIBBO ASSOC'IATES LLP' aaa PCHD X 001 PUTNAM COUNTY DEPARTMENT OF BEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ATTENTION 0 JOSEPH *GENE REQUEST FOR FINAL INSPECTION For: Fill All information must be fully completed prior to any Trenches inspections beizig made. t 5,1F gw /%r- PC.HD ConstructioD Permit# P-ci-.O(;; Located: (T) Owner/Applicant Nan, e: —TM 4q Block Lot 6-f- Fon-nerly- Subdivision Name: Subdivision Lot Is system til I. completed? Is system complete'? Date- 9?-19-1c2a Is System constructed as per plans? Klff6' Is well drilled? Date: A44 Is well located as per plans?--7�R R Axe.erosion. c.oritroi measures M place? --- I certify that the system(s), as listed, at above premises has been constructed and I havQ.i-nspected and verified their completion in accordance with the i sued PCHD Construction Permit and approved plan's and The Standards, Rules and lations o the Putnam County Department of Vz Date, Cerfifie. PE f -RA- sional 181BB0 ASSOCIATE$ -At CF NrW n .... -4 Q Address, 4- C;Omers, a NY I Comments. TEL.: 845-:278-7921 NAME., PUTNAM COUNTY DEPARTMENT OF P. 1 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Tim Allen Bibbo Associates Mill Pond Offices 293 Route 100, Suite 203 Somers, NY 10589 Dear Mr. Allen: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Field Inspection — Stillwell — P -09 -06 480 Route 164 (T) Patterson, T.M. # 24. -1 -59 August 24, 2006 The above referenced separate sewage treatment system can be backfilled. There are no open comments to be addressed at this time. - If you'have any further questions, please contact me at (845) 278 -6130 ext. 2261. GDR:kly Sincerely, Gene D. Reed Senior 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 -6685 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 Department. of Environmental Protection Emily Lloyd. Commissioner Tel: (718)595-6565- Fax (718) 595 -3557 Bureau of Water Supply 465 Columbus Avenue- Valhalla, New York 10595 -1336 David S. Warne Acting Deputy Commissioner Tei'!(914) 742 -2001 Fax!(914) 741 -0348, Joseph Maggio; P -.E:- Deputy.Director Engineering Division EOH - Tel. (914) 773 -4470 Fax;(914) 773 -0343 CITY DEPART 2` b D� 'hRDA'MENTALPR�tE� www.nyc.gov /deP (7 18) DEP'HELP . Michael Budzinski, P.E Putnam Co. Health Dept. 4 Geneva Road Brewster, NY 10509 Re: Stilwell Residence 480 Route 164 Patterson, Putnam East Branch Reservoir DEP Log # 2006 -EB -0801 Dear Mr. Budzinski: This letter is to inform you that the New York City Department of Environmental Protection (Department) has determined that the above - referenced application is complete. In addition, the Department has no objection to the approval of the above - referenced regulated activity. This determination is based on the review of submitted documents including the plan titled "Subsurface Sewage Disposal System" prepared for Joseph Stilwell, dated 6/21/06. The applicant must contact Sissy De La Cissa of my staff at (914) 773 -4416 at least 2 days prior to the start of construction of the SSTS so that a Department representative may inspect and monitor the installation: Sincerely, Danny Shedlo, P.E. Civil Engineer II Engineering Review Group xc: Roger Sokol, P.E., NYSDOH Town of Patterson Planning and Zoning Office Town of Patterson Building Department sv,;� ()i '' 1(SO.0 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # �— Cq —(!)CO Located at y fSn IZoosg jg44 Town or Village ?Per -m g. 0 Subdivision name Date Subdivision Approved Subd. Lot # Tax Map 'Z 1-1 Block ( Lot <'" ' ( Renewal Revision Owner /Applicant Name T o S e.? H GT 1 L w c_L L.- Date of Previous Approval Mailing Address 2(- 13 sL o A r w o4Y /y r oi Yo 2 x, Ii. Y, Zip /00OLt Amount of Fee Enclosed 4 66 O . c, o l Building Type j� ,Esj p N LF— Lot Area 1Z4. I'No. of Bedrooms b Design Flow GPD Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 2 o 0o gallon septic tank and 7 Vb d.�,� �►�a2 Other Requirements: I.5' R.O.R. FiiL FLoATiP4, 0U-TLS:' 'DosrNL-2 G14,gM9r"_2- To be constructed by i . 3. ,t7. Address Water Supply: Public Supply From Address or: t/ Private Supply, Drilled by % (3 . D . Address I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standar and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate ns mpliance" satisfactory to the Public Health Director will be submitted to the Department, and a " #e4izaraYiti i .furnished the owner, his successors, heirs or assigns by the builder, that said builder will place gatip 't y part of said sewage treatment system during the period of two (2) years immediately f tag u f the approval of the Certificate of Construction Compliance of the original Y s stem or Y re i t e Signe 43 81BBO ASS.4901ATMLL Date 4. z 1 0 6 2�u,5, Route 100 sufte Address License # 3 f -an APPROVED FOR CONSTRUCTION: This appro rs from the date issued unless construction of the sewage treatment system 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. Any revision or alteration of the approved plan requires a new ermit. Approved for ischarge of domestic sanitary s age only. By Title: Date: 1 6,- to White copy - HD Fi ; Yel w c py - Building Inspector; Pink copy - Ow er r; ge copy - Design Professional Form CP -97 +a w �•� v w w � w w N N �' ,_ �r OFFSET DIMENSIONS # ITEM I A B C D 1 STI 18.0' 48.0 2 STO 30.0. 3 DC IN 32.5' 60.5' 4 DO O 41.0' 68.0' 5 DB 41.0' 58.5' 6 TE 45.0' 62.5' 7 TE 48.0' 60.5' 8 TE 51.5' 59.0' 9 TE 55.5' 58.0' .10 TE 59.5' 58.0' 11 TE 64.0' 58.5' 12 TE 69.0' 59.5' 13. TE 74.0' 61.4' 14 TE 79.5' 63.5' 15 TE 84.5' 66.5' 16 TE 119.0' 131.0' 17 TE 121.0' 131.0 18 TE 123.0' 131.0 19 TE - 125:5' 131.5' 20 TE 128.5' 132.0' 21 TE 131.5' 133.0' 22 TE 135.0 134.5' 23 TE 138.0' 136.0' 24 TE 141.5' 137.5' 25 TE 145.5' 139.5' W. Mas 4003/a .) 000z THIS IS T CONSTRI WAS INS: WAS C01 AND REG AND IM 0 PUTNAM COUNTY DEPARTMENT OF HEALT DIVISION OF ENVIRONMENTAL HEALTH SERVICE CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM PCHD CONSTRUCTION PERMIT # — 0-4, Located at ! Town or Village ?kf - 61-3 -dn V Owner /Applicant Name , fin s e i? S' vii'' /!j,� �f Tax Map Block �_ Lot t Formerly Mailing Address Subdivision Name Subd. Lot # Zip /0001 Date Construction Permit Issued by PCHD 7 • / Z . 0 4r Separate Sewerage System built by 1 P Af s ,oA �x �/& 4 Address & ` °/ Consisting of Z&4&,4 Gallon Septic Tank and 75-0 ' irowcA 10Vtt ° I' P®. -Ore ChIAA 110V^ Other Requirements: Water Supply: Public Supply From. Address or: Private Supply Drilled by f' Address Building Type /h L' i Has Number of Bedrooms I certify that the system(s), as listed, built plans (copies of which are atta( plans and the standards, rules and 4 Date: ) 2.2 • o g Certified by Address 2 /A been completed? T le I 5' te.xi installed? Aza v remisd's were constructed essentially as shown on the as- eo' filie is,. ed<itiCHD Construction Permit and approved $I, CDebment of Health. P.E.G R.A. License # 73yJy Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval of the private water supply shall become null and void when a public water supply becomes available. Such approvals are subject to modification or change when, in the judgment of the Public Health Director, such revocation, modification Ar change is necessary. I _ White copy - HD File; )Yellow b = Title: - Building Inspector; Pink copy - copy - Design Professional Form CC -97 a tA CpG SHERLITA AMLER, MD, MS, FAAP L a ROBERT J. BONDI Commissioner of Health * County Executive LORETTA MOLINARI, RN, MSN YO .ROBERT MORRIS, PE. Associate Commissioner of Health Director of Environmental Health . DEPARTMENT OF HEALTH 1 Geneva. Road..Brewster, New York 10509 Town dal Bedroom Count & Proposed A.dditiod Status . Re: J��/I Zf Owner's Name) Tax Map•# Address: Town: Year Built: 11�6( .According to records maintained by the. Town, the above noted dwelling, is in. compliance with Town. Code. Is not in compliance with Town.Code, The Legal Bedroom Count is: This information has been obtained. from: _. Certificate of Occupancy: r Other: The .plans for the proposed. addition are considered:.. New Construction . Addition to existing .house-only Teardown and/or re =build allowed under Town Regulations _1Y _Date .. 6. Environmental Health (845) 278 -6130 -Fax (845) 278 -7p21 Water Supply Section X845) 225 -5I86 Fax (845) 225 -5418 Nursing Servi ces {845) 278 -6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278. -6085. WIC. (845) 278 -6678 Early Intervention Preschool (845) 228 -2847 Fax (845) 225 =1580 UTNAM NGINEERING, PLLE. Engineers and Architects July 1, 2014 Michael J. Budzinski, P.E. Director of Engineering Putnam County Health Department 1 Geneva Road Brewster, NY 10509 Re: Joseph Stilwell NYS Route 164 (T) Patterson TM #24 -1 -59 PCHD #P -09 -06 Dear Mr. Budzinski: The above referenced construction compliance was approved on 12/3/08. The approved floor plans showed an expansion of the house adding two bedrooms to the existing four bedroom floor plan, bringing the total bedroom count to six. - The septic" system construction permit was approved for six bedrooms and the system was installed and approved by your office as noted above. To date, the expansion of the dwelling has not been constructed. We are now submitting an "addition application" and new floor plans for an additional bedroom, bringing the total bedroom count to seven. Using the current 150 gal/day flow standard, a seven bedroom dwelling would have a daily flow rate of 1050 gallons, which is less than the previously approved 1200 gallons. The required length of 2" wide absorption trenches would be 6571.f. which, again, is less than the existing 750 l.f. of installed trenches. Finally, the septic tank installed and approved in 2008 is a 2000 gallon tank which is the minimum size required for a seven bedroom dwelling. (L01442) 4 Oro RouTE 6, BREWSTER, NEW YORK 10509 • (845) 279 -6789 • Fax (845) 279 -6769 At this time we are requesting an approval for the construction of the seven bedroom layout. Attached is an "Addition Application ", a copy of the existing floor plan, two copies of the proposed floor plans, the $100.00 fee and certification of bedroom count from the Building Inspector. Please contact me if you have any questions or comments. Sincerely, PUTNAM ENGINEERING, PLLC RJZ /tal Atts (LO1442) PUTNAM ENGINEERING, PLLE. Engineers and Architects 4 0co RouTE 6, BREWSTER, NEW YORK 10509 • (845) 279 -6789 • Fax (845) 279 -6769 ALLEN BEALS, M.D., J.D. Commissioner of Health ROBERT MORRIS, P.E., MPH Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 September 22, 2014 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Putnam Engineering Richard J. Zapp, Jr. 4 Old Route 6 Brewster, NY 10509 Re: Addition — Approval — Stillwell No Increase in Number of Bedrooms 480 Route 164 (T) Patterson, T.M. 24 -1 -59 Dear Mr. Zapp: MARYELLEMODELL County Executive This Department has 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 September 22, 2014. The addition is approved with the following conditions: 1. The existing SSTS is now large enough for seven potential bedrooms based on the new design flow of 150 gallons per day per bedroom. 2. The total number of bedrooms must remain at seven without prior approval by this Department. _3_ The area of the existing sewage disposal system and its expansion area must be - maintained. 4. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc ... 5. The approval is for the modifications only and does not validate any construction shown as existing that has not obtained proper approvals from other agencies having jurisdiction. 6._ This. .approval..is -valid.for.xwo.�2) years and expires on September 22, 2016. Any permits or variances required under the jurisdiction of the Town of Patterson are the responsibility of the applicant. If you have any questions, please contact me at (845) 808 -1390 ext. 43157. Res ectfully, J seph S. Paravati, Jr., P.E. ssistant Public Health Engineer JSP:cml cc: BI (T) Patterson