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HomeMy WebLinkAbout0012DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 3. -1 -12 BOX 1 1 11 ,. HI . 91 rmfj 06 ti 00012 w_ P LORETTA MOLINARI R.N., M.S.N. 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 September 5, 2003 Mel Fichera 112 Manor Rd. Patterson, NY 12563 Re: Addition- Fichera, 112 Manor Rd. No Increases in Number of Bedrooms (T)Patterson, TM #3 -1 -12 Dear Mr. & Mrs. Fichera: ROBERT J. BONDI County Executive I have received and reviewed the plans for the proposed addition to the above - mentioned residence.. The proposal for the addition has been approved as per plans bearing the approval stamp from this Department dated September 5; 2003 The addition is approved with the following conditions: 1. The total number of bedrooms must remain at four without prior approval by this department. 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Patterson. If you have any questions, please contact me at your convenience. Very truly our William Hedges WHArn Senior Public Health Sanitarian cc:BI T T T T T _ PUTNAM COUNTY HEALTH DEPT. -025661 Y 1 Geneva Road (845) 27"130 Brewster, NY 10509 Date Received of The Sum Of Dollars $ 10c',00 For % t/ 4,3 THANK YOU! ❑ Cash 2'Check ❑ M.O. Q Credit Card By J e DE PAR i lYEIv I OF I-MAI.T.1-I Z*Won of Environmental health Services 4 Genava Road Brwvsur, New York: 10509 Tel. (914) 278.6130 Fax (914) 278 - 7921 BRUCE R Fuzy Public Hecirh Dir:c!cr STREET//,,,2 TOWIN r, �r 03 NAbE ! �S" -� �,ur, PHONE PCHY) r _ IM—A=i(a ADDRESS DESCRIPTION OF ADDITION 1 r L NEBER OF EXISTITNV G BEDRO0 PROPOSED # OF BEDROOMS � (FROM MAT. OF GCC1r.'AtiCY OR CERTIFICATION FROM SUILOLNG INSPECTOR.) *Any addition «hich is eo=Ur ed a bedroom tequires formal approval of plans (ConsstrucLion Permit) prepared by a = rof:ssio:.21 En; ineer, or Registered Arc'l tect in accordance with applicable sections of the Pum= Co-zaty Sarutaty Code. Please submit this fort+: ar ;.d the fo:loMng to Putnam County Health Dzpt., 4 Geneva Rd., Bmw5s ar, INTY 10509, Phone 278.6130. 1. Certified check or money- older for 5100.00 S�.tches of existi*rg floor plan (drawn to scale, all living area Including basement) * Non - professional sketc'n=s arc accept =ble 3. Two sets of proposed Zclor plan (drawn to scare, with name, street, and tar: rap r) * Noa -pro *.ssionai sketches are acceptable 4. Copy of sarycy s :owing well and septic location, to the best of your kLna ledce. Include date of ins?allation if Label all wells and septic systems witnln 200 feet of the property line. Contact this office wit, any questions. 5. Copy of Cent. of Occupancy front Town or Certification from. Buildirs Dept. with legal bedroom count of dtivelli a.____. QFF1f:E USF. Cornmel.s , PHILLIP ::b 93 i CERADINI ARCHITECT AIA 3 NORTH U10 M C ER VE 7. 96 co NEW A YORK 10340 811. 037 FAX; 914.888.2388. DEPARTMENT OF HEALTH Division . Of Environmental Health Services Geneva' Road, Brewster, New York 10509 (914) 278-6130 Pu*.mmm County Dept. of Health 4 Genm!a Road 3:cwstrr, NY 105C9 G6nd men: BRUCE R._FOI.E�. P c Acting Puhile Meal th.0 ;- a -t.�� Re: Residenco Tax map -3, Tom Accotdi.ng to re:,ords mainta'Med by the Town, the above noted dv eliing i5 >- IS i1Qi in cor7pliam, kith To,�,,. codo and tf,�e tc al number cf'oedroarn5 on record is This infomation ,aas been obtained from: A.- L, Qr 4CCUFAiNCY: A- 3ES -50M R:KORD: 0- &MF;R Suiidin� inSCictOf �ANoR R• 300.00' e* Sc'- S ?'_ off„ R O N 4 � o \ z T r vt 4 h n 1� x� .N c M v4 R+ v N <z 5Ole, of•441' �t.Oi • �s as L � Imo-' Ina 5 0� P-All=w All K -moo' a- SIr -W-1b 23.47� r R.r�O.oa' �. TI' -3'{'• 94�� l:r 62.13 N r h N Z N � Y � x�� 4 4- 8 T &� t- loo Iol Im3/i lore rLIT G25 8! u2 h N Z N � Y � x�� C� PUTNAM'COUNTY DEPARTMENT OF HEALTH DIAako of Eovlronmentil Heel& Service., Caeme1,14 V 10512.. ` M qqA �hseer aat Provide F PX D Permit N CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Town or, VlDage MAt 4 O %..� T" Map Blodi t Lot 2 /apppcant Name - Formerly SubdivUlon Name Mawng Asa a i. iN��E �i_ -AaN �N `L PP io bO S SU-Mv. Lot # 1 �" Fee. Enclosed [� Amount; Date Permit Issued_- Separate Sewerage System balit by 1^ 4 OKESV*V-- . A��OC Address A2 l.�` i2SO X8.6. �. F. ABSof -9t Consisting of Gallon Septle Tank and _ _ Water Supplyt Public Supply From .Address or: Private Sappiy Drilled byljt -� SC)1 Address .E.. - J�> P'i011�:-4— BauamgType plsiDCt3t�<a.� -- . Lot Size g%i H as, Erosion Cnntrnl Roan ('nmolPrp��.�s Number'of Bedrooms Has Gubage Grinder Bees Installed? Otber Requirements . I certify that the systems) as listed serving the above premises were constructed as a 11 as shown on plans.oi the completed work -.( copies of which are attachad),`and in accordance with the standards, rules and re u b, with the-fi plan,' and the permit issued by'the Putnam Coun par n Of Nealth. Data Certified by P.E. RA -� cps�N asS ©c� Aderesi. f.C, •gip d {x,2.2lwstz o�gUS.= � Lignsa No. Any person occupying premises served, by Ana above systmm(u -shall promptly take such action'as may be necessary to an we the correction of any unsanitary conditions resulting from such usage. Approval of the separate sawerMa system shall bf— n*null and void as soon as a publ'= sanitaiy siwar becomes, available end .the approval of the private water supply shall become null and vokl`.whon a public water supply bee n nN!:- evatlsbN. Such 'ipprovala are subject to modification or change when, in -the Judgment of the Commil such revocation, modification or' change b, necessary. _ 3/89 MV w4. r7er� PUrDIAM COUNTY DEPART OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Owner or Purchaser of Building Building Constructed by N11A /1`-jdrof- � f �:) Location - Street Municipality `5 I N�- L-F, rA.lV-N. C I Building Type GUARANTEE OF SUBSURFACE SEWAGE ,-�5 I j2 Section Block Lot Subdivision Name I � Zo Subdivision Lot # .° .4 _Mrn > _rn 2:b Z; DISPOSAL SYSTEM N C<7-C I represent that .1 am wholly and completely responsible for the location, worknanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shcwm 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 disposal 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 Director of the Division of Environmental Health Services of the Pu main 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 this 9 day of 19� Signature ?Seneral Contractor (Owner) - Signature Corporation Name (if Corp.) 5yi" Address rev. 9/85 mk Title 1orMes1'7-1-fissor...lAJc . Corporation Name (if Corp.) -Yd &66lc (idcli/L,4.. Address i ., 9 a WELL c;UriYLt;rtuLV xr,rUl<i Office Use Only DEPARTMENT OF HEALTH Division Of Environmental Health Services ` PUTNAM COUNTY DEPARTMENT OF HEALTH WELL LOCATIONS ADDRESS: ►`rN! I TAX GRID NU SEA' 5' AD WELL OWNER AME: ADDRESS: NT" h' p PgIVATE O PUBLIC USE OF. WELL N&RESIDENTIAL O PUBLIC SUPPLY 0 AIR /COND./HEAT PUMP 0 ABANDONED �F - imar ? O BUSINESS ❑ FARM O TEST /OBSERVATION O OTHER (specify)*. 2 - secondary _ ' 0 INDUSTRIAL 0 INSTITUTIONAL ❑ STAND -BY 0 MOUNT OF USE 'YIELD SOUGHT -� gpm. /NO. PEOPLE SERVED / EST. OF DAILY USAGE y ' 'gal REASON FOR;;;. ..[]REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION ❑ADDITIONAL."WPPLY: DRILLING. "SNEw SUPPLY (NEW DWELLING) ❑DEEPEN EXISTING WELL DEPTH :DATA WELL DEPTH o�S� ft. STATIC WATER LEVEL 0191 ft. DATE MEASURED DRILLING 0 ROTARY `&COMPRESSED AIR PERCUSSION 0 DUG EQUIPMENT ._ _ O WELL POINT ❑ CABLE PERCUSSION 0 OTHER (specify): WELL TYPE A; 0 SCREENED O OPEN END CASING OPEN HOLE IN BEDROCK O OTHER TOTAL LENGTH — ft MATERIALS: STEEL ❑PLASTIC D OTHER CASING ,�.;: LENGTH BELOW GRADE ft. JOINTS: p WELDED )9 THREADED ❑OTHER DETAILS; DIAMETER in. SEAL:% CEMENT GROUT OBENTONITE 0OTHER WEIGHT PER FOOT Ib. /ft. DRIVE SHOE�.YES O NO LINER: O YES ONO SCREEN DIAMETER (in) SLOT SIZE LENGTH (It) DEPTH TO SCREEN (ft)' DEVELOPED? FIRST O YES O NO _ DETAILS . SECOND } >: HOURS GRAVEL PACK O YES GRAVEL ... DIAMETER TOP >.,: BOTTOM tz t# , +r ONO SIZE: OF PACK in. DEPTH fL OEM `It. WELL YIELD TESL.;,.-` -t- detailed pumping 'WELL LOG If more detailed formation descriptions or.sieve analyses €T . available, please attach. METHOD O PUMPED t tests were done is in- I `&COMPRESSED DEPTH DEPTH FROM Water Well � � AIR , . ormation attached. O fiAILED " ?`.l7 OTHER ; ❑YES O N0 SURFACE Bear. ho Oia- peter FORMATION DESCRIPTION ,,..� ; ". COME It. rt. WELL DEPTH DURATION DRANlOOWN YIELD Land t9 Q� It. hr. min. It. gpm. WATER'"6�ClEAR ;;. TEMP, n-1 QUALITY- O CLOUOY ': HARDNESS O COLORED ANALYZED? **WES ONO STORAGE TANK: TYPE tk 111M JU CAPACITY W�- O GAL. ANALYSIS ATTACHED ?'*GJES O NO PUMP IH UAMATION .` "'. C TYPE S `t CAPACITY WELL DRt44LEA IVAME 7 'ToCL`�S� MAKER MOOEL I O < VOLTAGi Q HP DRESS �Q o s NATURE ? s. tj V_ tj , L. J/ U7 h: a'4 YML ENVIRONMENTAL SERVICES 321 Kear Street xer� Yorktown Heights, N.Y. 10598 E ( 914) 245 -2800 `s f y � Albert H. Padovani, Director 1� J 1 SLAB #S 33.400145 CLIENT #: 114 NON STAT PRGC PAGE i rfMNNN T NN NN NMN NNNNNN---------------- ---- -- ---- ---- -- --------- IVNNNNNN NNMNNNNNNNNNN TORL I S H , & _ SONS ` DATE /TIME TAKEN: ,03/02/.94- 13:30 `. ' '.BOX 2717' - '` DATE /TIME REC'DS 08/02/ 9C-4 4 30 ATTENTIONS!'DWAYNE TORLISH REPORT DATE: 08/03/94 ARMONK, NY' 10,904 PHONE: (914)-273 -3448 SAMPLING SITE: AMICUCCI DEV LOT 14 SAMPLE TYPE..: POTABLE+. .� _ '., PATTERSON PRESERVATIVES: NONE - .- ' GL' D 8Y: :'D. TQRL I SH - TEMPERA'LURE:. a ;.< 40 I NGTES..'.::' COLIFORM METHS MF �NNNNNN NNNNNN NNNNNNNNNN-------- --- ---- -- ------ --IY -- ---- -- - ----NN NN MNNNNNIVNNNN ,. FLAG PROCEDURE RESULT NORMAL — RANGE 08/03/94 MF T. COLIFORM ABSENT /100 ML ABSENT COMMENTSS -'' 'BACT THESE RESULTS INDICATE THAT THE WAT W (WAS NOT) OF A ' -` SATISFACTORY SANITARY QUALITY ACCOR ING TO THE NEW YORK STATE r: AND:'EPA..rFEDERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED, AT THE TIME OF COLLECTION. :.f t v J Y y'' a p - 4 aUBMITTED.BY:---- - - - - -- - - -- - - -- _ Albert H. P dovani, M. T.(ASCP) Director ELAP# 10323 Renewal— 0—Reorliden-0 ow..dAp��eelt 14 ' '1 0 � 1 1 fi /�� G I *T Date of Peevbo App"" M•�s 2 C6r mAe r,-� o T... -W HIM PbAw5 zip l C>60-5 Dare Subdivision AQproved ! Fee Enclosed ❑ Amn„nY � Gil ►` t-ei mn Lot Anal I I (ob sl % Pm Seedo. sad, D vdome Nlseeier et Bee)tgae�a D-I& Flow G P D �+ > 0O � PCSD Notlflratloa k Requked Wbea Fm b e�pkted Jsep-aft s..r..r SFN� to eoedet 250 T, asd_ —� T. ba:aedeeeMd I T-Q Addleee Wa/or sw*; P SW* Fear Aare.. «r --Pdrate Selppil DOW �� 15S D �T • .adr.+.. 066 Regmilmoselds 1 repr~t'.thet 1 am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal •stem above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules a rpu qns o Dam County Department of FleaRh, and that an completion thereof "Certificate of t:onetru n Compliance" satisfactory to the Commissioner of Healthwill be submitted to the Department, and a written guarantee will be furnished the owner, successors, hells assigns by the builder, that aid builder will place in good operating condition any pert of said sewage disposal system durirp the of two (2) s Immediately following the Wee of the Iswr apes of the approval of the Certificate of Construction Compliance of the w 1 any repair hereto; Z) that the drilled well described e6011/ will be located <t n that approved plan and that said well will be Installed in ith the rds, rules and rpu ns of the Putnam COUntY rt FIM h. Oate Z7 � Signed P.E.- RQ:A. �► PC Z GIB r License No 6 119120+ 1 Address r- APPROVED FOR CONSTRUCTION: This approval expires two years from the des issued unless construction of the building .has been undertaken and is revocable for Ouse or may be arvies or modified when considered necessary p the Commissioner of Health. Any charge or alteration of Construction squires a new per Appr ved for disposal of domestic sanitary sewage / tvate water supply only. Rev. -- Date 8Y� Title 10/88 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL �f PCHD PERMIT # WELL LOCATION Street Address Town/Village/City Tax Grid Number T1At low P& E rp ' '3. r I - 2 WELL OWNER Name Mailiny� Address �-}olrt�5( � aG fv `1'z &LZ- C-LQ 9D H PI.AiMg >trivate M40 Public USE OF WELL 1.- primary 2 - secondary RESIDENTIAL 0 PUBLIC SUPPLY 0 AIR /COND /HEAT PUMP D BUSINESS O FARM O TEST /OBSERVATION D INDUSTRIAL []INSTITUTIONAL O STAND -BY ❑ ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT-01M 5 gpm /# PEOPLE SERVED1PAM/EST. OF DAILY USAGE G0gal 13 PEPLACE EXISTING SUPPLY 0 TEST/ OBSERVATION CIADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING 0 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN ODUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES \( NO IF WELL IS LOCATED � IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: �I�/11n1 Gpvn Lot No. zt WATER WELL CONTRACTOR: Name `r0 �J6 i7 (5- Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: jjz % TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION KETCH & SOURCES OF CONTAMINATION PROVIDED / PON SEPARATE SHEET �7 at ( ure) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirt -y (30) days of the completion of water well construction, the applicant 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 attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling 3perations, the applicant shall take appropriate action to assure that any and all water or 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 grou dwater. Date of Issue: Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller DESIGN DATA Sii=- SUBSUFACE SEWAGE DISPOSAL SYMER FILE NO. owner Address �-2 Located at (street) MPU-NM 90,k� - Sec. Block Lot (indicate nearest.cross street) municipality 1"P'T'T����+�i�I Watershed G2 -c�Tn ry • • ' 71 -�• •' Yy. a • Y• - �• a' �a • : ■ Yea •/• •' Date of Pre - Soaking Date of Percolation Test HOLE NURSER CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water From mater Level No. Time Ground Surface In Inches Soil Rate Start -Stop Min. Start Stop Drop In Min /In Drop Inches Inches Inches E1 2 3 4 F 5 I z lO f-1IN /IN 3 4 5 1 2 3 4 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are cbtained.at each percolation test hole. All data to'be suimitted. for review. 2. Depth measurements to be made fran top of hole. TEST PIT DEP'T'H HOLE NO. G.L. 2' 41 5' 6' 7' 8' TO BE SUM= WIM APPLICATION HOLE NO. HOLE NO. 9' 11' 12' 13' 14' INDICATE LEVEL AT WHICH GROUNDWATER IS ENCOUNTERED INDICATE L= TO WHICH WMTER T= RISES AFTIIZ BEING ENCOUNTERED DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN Soil Rate Used o Min/1 ".Drop: S.D. Usable Area Provided -�T- No . of Bedrocros Septic Tank Capacity 2 �i -� gals. Type Absorption Area Provided By L.F. x 24" width trench Other Name i� i� -�[-F (lamG l,� ��j� G.. Signature, �`� A VW Address �� C�'� L SEAL $ THIS SPACE FOR USE BY HEALTH DEPAM= ONLY: Soil Rate Approved sq.ft /gal. Checked by Date - f !• •• ■ �1' ift 1� II y is ■ •' • ]� ■• •: I�r Y• :ly is �' •1� DESIGN DATA SID=- SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO., owner ftoMjr: 1,&`T1S Address �Z GoB�.��(� �p 11��1(� (L.&, 's Located at (Street) Sec. '� Block l Lot (indicate nearest.cross street) M.Imicip3lity �%�'C'T����l`t Watershed - G2 -vT40t r- 1 Date of Pre - Soaking Date of Percolation Test HOLE NU MM CLOCK TIII PERCOLATICN PFD' 'tCO=CN Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In Inches Soil Rate Start-Stoo Min. Start Stop Drop In Min /In Drop Inches Inches Inches 01 2 3 4 5 i z 10,MIN / IN 3 4 5 1 2 I�t7I�S: 1. Tests to be repeated at same depth until approximately- -equal soil rates are obtained at each percolation test hole. All data to' be submitted for review. 2. Depth masiarements to be made free trip of hole. . DEPTH HOLE NO. HOLE NO. G.L. 1' 2' 3' 4' 5' 6' 7' 8' 9' 10' 11' 12' 13' 14' TaP.c,- r Z- t -&Y K= N-J HOLE NO. INDICATE LEVEL AT WHICH GROUNLFATER IS EMAUNTERED INDICATE LEVEL TO WELCH DATER LEVEL RISES AFTER BEING ENCOUNT= DEEP HOLE OBSERVATIONS MPDE BY: DA'T`E: DES I -CD1 Soil Rate Used �O _ Min/1 ".Drop: S.D. Usable Area Provided No. of Bedroans Septic Tank Capacity ZC�� gals. Type .Absorption Area Provided By(� L.F. x 24" width trench Other Name Gir. C- . Signature � o P.dciress �T� 2Z SEAL ;4 ; THIS SPACE FOR USE BY . fl ALTH DEPARIT. ONLY: �� rt- -► Soil Rate Approved sq.ft /gal. Checked by Date