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Home My WebLink About0203DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 4.15 -1 -5 BOX 3 00012 Ott 4. it. - L } .' r 00012 . LORETTA MOLINARI R.N., M.S.N. Acting 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 /Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Helen Yannantuono 69 Sunset Drive Patterson, NY 12563 ROBERT J. BONDI County Executive April 17, 2003 Re: Proposed Accessory Apartment (T) Patterson Dear Ms. Yannantuono: I have received and reviewed the preliminary plans for the proposed accessory apartment at 69 Sunset Drive (T) Patterson. Please complete the enclosed application including the five (5) items listed on the reverse side. Should you have any questions, please contact me at (845) 278 -6130 ext. 2168. WH/JP Enc. Very truly yours, William Hedges Sr. Public Health Sanitarian Helen Yannantuono 69 Sunset Drive Patterson, New York 12563 Phone: 845 - 878 -4023 April 7, 2003 Mr. Bill Hedges Department of Health Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Dear Mr. Hedges, In regard to our phone conversation a few weeks ago, pertaining to the proposed expansion to my home at the above address, I am submitting, for your review, copies of the existing septic system, survey, and a rough sketch of the proposed expansion plans. I would like to expand the existing square footage approximately 830 square feet to accommodate my two- elderly parents. Ideally the expansion would consist of a bedroom, a full bathroom and living room area and one -car garage. The one -car garage would be adjacent to the existing two -car garage. Currently we are a family of four living in the existing residence. Your courteous and sincere interest in this matter is greatly appreciated. I look forward to receiving additional instructions and information from you on expediting this process. 4eule(�n r annantuono Enclosure (3) ut �:1 V T_ tj 71 C� -rAN A` S&7 ?�P_H C/Y -4 vv r 14 i 13 57 AN 70 -0 �q 1 ' ' I ' 1 , 3r e o_ � �+�i. .3 104 9, 11 '-D' 0 ,j-jroved asnoted for conformance With fa V(3 L14� IA q glioable, gulee and Regulations of the Cjje- lutnm County Health Department... � iL7, 5,cF7ic_ s!—_rP_A1\ urn 1 tI P PtP j. C/Y -4 vv r 14 i 13 57 AN 1 ' ' I ' 1 , 3r e o_ � �+�i. !,,ision of Environmental Health Service.17c0 �AL, AV g.,f _,epTIC_ ' ' �� ' �t ,j-jroved asnoted for conformance With fa V(3 L14� IA q glioable, gulee and Regulations of the Cjje- lutnm County Health Department... � iL7, 5,cF7ic_ s!—_rP_A1\ urn 1 tI P PtP 9 - ca FAA:P -TAT&S C/Y -4 vv r 14 i 13 57 AN -sl AN3 C" q4� 74- ait, � _71-11, OF ------- ------- i t, �, I I " I� I �" I, � -, 11 i i I� �� I� �i i I" I I 29 0 0. del 3.208 AC. 0 4 0 DECK 0— FRAME bb DWELLING WELL I OA CURVE DATA:IN,- 45* 10'54" Cb 0 L= 177.4 3� 3 UT ILI TIES RIDGE e- NOTE: REFER TO MAP TITLED, "FINAL PLAT. SHOWING QUAKER RIDGE ESTATES, R-40 ZONE TOWN OF PATTERSON, PUTNAM COUNTY, NEW YORK, SCALE: I "=100' TOTAL AREA: 61, 978 AC. DATED: JAN. 24, 1984 REVISED THRU APRI L. 5, 1984 FROM THIS OFFICE. M Putnam County Department of health Division of Environmental Sanitation AFFIDAVIT - CORPOWiTE C14NER APPLICATION FOR PERMIT APPLICATION SUBMITTED TO PUTNAM COUNTY IIEALTFI DEPARTMENT TO: Com,:issioner of Health - In the matter of application for U I -_ 0,fi� /X -- s /s7F1V - - - - - — — — — — — I Aj % (/� �s' , represent • - - - - - - - - - - - - - - that I am an officer or employee o`fj the corporation and am authorized to act for ___ burew _/`1d1�JGS .�/ ✓�'. ---- - - - - -- (name of corporation) having offices at -CS - — - - S��cI }L _� �,3 Whose officers are President - /I%f1/?lG /!l_ ✓� AJV&14E -5- - Sf}llg "4S I- oVE - - - - - - (Name and Address) Vice - President . S1114)i _ _ _ (Name and Address) r" Secretary ---- - -��- - - - - - - - - - - - - - - (Name and Address) Treasurer — ___S,9/rJ� -- — — — — — — — — — — — — (Name and Address) and that I am and will be individually responsible for any or all acts of the corporation with respect to the approval requested and all sub- sequent acts relating thereto. Sworn to before me this c2�7 day of Notary Public CHRISTINE VAWINCE Notary FUMIC. Slate of NOVA Na Oi A4S100 - . 4uali ied In Oi t Ooltii Commission EXPIM , Signed Title _PkeSlb6/0� - ^ - -- Corporate Seal PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SE14AGE DISPOSAL SYSTEM FILE NO. „ Owner 1✓U7 {FdZ 4M.ES ::�)C- Address l Located at (Street }��i�Y�Sec. Block Lot nearest cross .s reet Municipality �/�,�/ Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMI ED WITH APPLICATIONS Hole- Number CLOCK TIPS PERCOLATION PERCOLATION Run Eiapse. Depth to Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min.. Start. Stop -Drop in Min. /in drop Inches Inches Inches ,5 2 3 - 4 5 Notes: 1) Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole." All data to. be submitted for review. 2) Depth measurements to be made from top of hole. / 2L tZ- Z 3 zq 3 3, Z5---4-4Q 7 2 Z� i 1 �Z �4s- ?,Fi ce 16' 2 Q%_'3 tQ 78 -- : 3 --- 3,3170 1411 -1&. j- Z4 ,5 2 3 - 4 5 Notes: 1) Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole." All data to. be submitted for review. 2) Depth measurements to be made from top of hole. / TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION. DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES INDICATE.LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING. ENCOUNTERED ., ,:-;�,; TESTS MADE BY Date DESIGN Soil Rate Use n/1 "Drop: S.D._.Usable -Area Provided,,Z5. = No. of Bedrooms aj Septic Tank Capacity 000 Gals. Type X4 ff� 0 f'j Absorption Area Provided ByASZ��L.F:x24 11 _fi6"— width trench.' Other :3 PJLL ? c� Address SEAL t*WA0Z0 tslL THIS.SPACE FOR USE BY HEALTH DEPARTMENT ONLY:. Soil Rate Approved Sq., Ft /Cal.. Checked by 0 v FESStON �, Wetlands on/or proximate to property.............. Property lines or corners found.... ............... Can estimate house location ....� .................... Willdriveway need cut ............................• Must trees be removed - note these ................ Deep holes representative of entire SDS area...... Additional deep holes needed ...................... Sufficient SDS area available considering driveway cut, house location, separation distances etc... Adjacent wells/ septics ............................ House SSDS located per approved plan...........,.. Length of trench measured (0' G C� Width of trench average Slope of tile line and trench acceptable......... Rocca allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded ............................ 10 ft. maintained from property line and 20*ft. from house... .......... Distance well to.SSDS (ft.).....G. ?............ . Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater. than 15 ft. from nearest trench ................ 15 ft. of peripheral soil horizontally fran trench ..... ............................... Boxes properly set ................ 0.0............ Could surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL C�2ADNG OF SITE A��TABLE.:. ................ x Q.I1 b s, �c EV I D.H. - Deep Hole G.W.- Groundwater D.H. 1 Lot D.H. 2 Lot D.H. 3 Lot Depth to G.W. Depth to G.W. Depth to G.W. Depth to rock Depth to rock Depth to rock Soil Descri tion Soil Descari ion Soil Descri tion 0 ft. 0 ft. 0 ft. �8 ��IcaS 3 ft. 3 ft. 3 ft. .6 ft. 6 ft. 6 ft. 9 ft. 9 ft. 9 ft. 12 ft. 12 ft. 12 ft. ' DATE: FINAL SITE IlJSPECTION INSP.BY: YES NO CCINA�T House SSDS located per approved plan...........,.. Length of trench measured (0' G C� Width of trench average Slope of tile line and trench acceptable......... Rocca allowed for expansion trenches .............. Over 100 ft. from watercourse .................... Natural soil not stripped or SDS area unnecessarly graded ............................ 10 ft. maintained from property line and 20*ft. from house... .......... Distance well to.SSDS (ft.).....G. ?............ . Number of bedrooms checks ........................ Stones, brush, stumps, rubble, etc., greater. than 15 ft. from nearest trench ................ 15 ft. of peripheral soil horizontally fran trench ..... ............................... Boxes properly set ................ 0.0............ Could surface runoff from driveway, roads, ground surface, etc., channel near SDS area.... Does lot drainage appear OK in area of SDS....... FINAL C�2ADNG OF SITE A��TABLE.:. ................ x Q.I1 b s, �c EV I Division of EnviroImentel Health SOIVICes, (.e[IDe1,1V Y.., 1U51Z ,r t .�-„ j .„y. s . 2Engfiueer Mast Provide t% G + ti -io SyaINN,' CERTIFICATE OEfCONSTRUCTION.COMPLIANCE:FOR SEWAGE 41 Sy" `P j j5o PIS, ILI r s Town or Village, +F x ted at fQK 6M ,,,, �Block�Lot y. y Rtu�eoMS ri�G 0 er/ "llcant Name Formerly Snbdivlston Name FS"r Sabdv ALot q b aPP tzft� `vX z panFxsf7n1 i� zip i53 fin MaWng Add:ese Date Permit Issued DLITf i2 MI65 I�IG SZ(2� �X 13 `dPF�TTIMO1�- Separate Sewerage System ballt by Address } Consisting of Gallon,:$eptic Tank and Water Su I s ; Pp y PaliHc Sapply From' Addroee ors U Private Sapply Drilled,by� Addrosa �/" ►� C-04 I r� V melon Control Been Completed - Has E Y 44amber'of Bedroomst M 9 '•Has Gaibage Grinder Been InstalledY tr IOtber Requirements �� •- - T .: , ... ., LIB - I certify that the system {s) as listed serving the, abovefpremises were constrveted.essent>ally asFehown on the § of the =completed work ( copies of which are attached) 'and in accordanca;wihh the atandads rules and regulations' i accordanc ith fi ed plan and•zthe permit issued by the -Putnam County Department YOf Health ;. r t Cert�fletl P E R A. Any parson occupying premises servetl by the above iystem(si; shall promptly tike such - action as nuy be nepisary to secun'tM cor► ctlon of any up",! tary contlitfons resulting from „inch usage gpproval.of ,the separate sewerage system shall become null and, voltl as soon at is pub n sanitary =ewer beeoinss iv, sl abI' 'antl ttie' approval ,o� the 3p►wate water supply shall become null and "vokt when a: public w� itlei -S p ply °tieeortiis awilatile. Such aDp ►ovals are �subJeet- -to,�modificatlon or= changeRwhen^--in the Judgment .of the Commissione�of Health, weh ievoeation,amotllfiution o► change Is necesYry Date r �� .__� •,8 ' Title z. 0 . A��Ir .,�wmT T]mTnuT nTnnnnm ��• a. O WILL t,vrrr 1..r1 i i.vi14 "I" V".L DEPARTMENT OF . HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only STREET AGURESS: TOWNIVICEIGLICIN TAX GRID NUMBER; Playland Court Patterson WELL LOCATION WELL OWNER NAME: ADDRESS: Dutcher Homes R.R.. 4 Box 73 Patterson, N.Y. 12.563 (� PRIVATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary (7-RESIDENTIAL .❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP O ABANDONED ❑ BUSINESS ❑ FARM O TEST /OBSERVATION O OTHER (specify) O INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY p MOUNT OF USE YIELD SOUGHT 5 gpm. /NO. PEOPLE SERVED 5 / EST. OF DAILY USAGE 500 gal. REASON FOR DRILLING X) NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST / OBSERVATION O REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 285 ft. STATIC WATER LEVEL 36 ft. DATE MEASURED 11- 26 -.86 DRILLING EQUIPMENT ❑ ROTARY m COMPRESSED AIR PERCUSSION O DUG ❑ WELL POINT ❑ CABLE PERCUSSION O OTHER (specify): WELL TYPE ❑ SCREENED ❑ OPEN END CASING 19 OPEN HOLE IN BEDROCK 0 OTHER TOTAL LENGTH 106 tL MATERIALS: STEEL O PLASTIC O OTHER CASING DETAILS LENGTH.BELOW GRADE 105 ft- JOINTS: O WELDED LJ THREADED ❑ OTHER DIAMETER 6 in. SEAL:] CEMENT GROUT O BENTONITE POTHER WEIGHT PER FOOT 19 Ib_ /ft. I DRIVE SHOE 29.YES ❑ NO UNER: O YES. 8 NO SCREEN DETAILS DIAMETER (in) . 'SLOT SIZE LENGTH (1t) DEPTH TO SCREEN (ft) DEVELOPED? FIRST ❑ YES o NO HOURS SECOND GRAVEL PACK O YES ❑ NO GRAVEL. SIZE:. DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM DEPTH ft. WELL YIELD TEST ' If detailed pumping METHOD: ❑PUMPED 1 tests were done is in- E COMPRESSED AIR , formation attached? O 8AILED O OTHER ; O YES ❑ NO V�IELL LOG It more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water Bear- ing We11 Oia- In FORMATION DESCRIPTION ME. ft. it WELL DEPTH It. DURATION hr. min. DRAWOOWN ft. YIELD 9Cm Lurid Surface lb Sand & gravel o ver ur en 10 90 Clay. 285 6hr 285 20 90 28 Grey & Wh. mica sc i WATER ❑ CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? ❑ YES ONO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE CAPACITY GAT. PUMP INFORMATION TYPE MAKER MODEL CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME Boyd Artesian, e Co. , Inc. DATE Rt. 52 12 -29 -8 ADDRESS Carmel, N . Y . c RE y ; 10512% PUTNAM COLTUrL DEPARTMENT OF HEALIR DIVISION OF ENVIRONMENTAL HEALTH SERVICES ,1iMI-Id AIV V- 9.51-6 C IO )//I- AW,41yT -d o- Nd Owner or 'Purchaser of Building Building Constructed by 6)U,41 at ILOlb6t Location - Street N iU Municipality r-loom� - a sT6 ,ey Building Type ;e t4n Lot 147,4 R SST /GMT` QU, E/c ff),S 6 f- �s ✓' Subdivision Name Subdivision Lot # GUARAN`rEE OF SUBSURFACE SEWAGE DISPOSAL SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it 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 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 Environinental Health Services 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 this 190 day of 19 Signature Title General tra tor�al ( ) - Signature - ignnature Corporation Name (if Corp.) Address rev. 9/85 mk ... - �; , Address Yorktown Medical Laboratory, inc LAB I Iry gip, c,0 6o 321 Kcar Strcct Yorktown Hcights.N.Y.10599 Collection Stat.lon Used: (914245.3203 Carmel Peekskill:..___ Director: Albert H. Padonani AL T. (Asaj Mt. Kisc Nev City _ r Sb( Date Taken: 5i Date Received: Date Reported: Collected By: Referred By: L�I J. Sample Source: LABORATORY REPORT ON—BACTERIOLOGICAL—QUALITY OF WATER GENERAL BACTERIA n 011 Standard Plate Count per 1.0 ml` (Agar plate .@ 35 °C) MEMBRANE FILTRATION TECHNIQUE (MFT) Total Coliform Der 1.00 ml Fecal Coliform rer 100 ml - Fecal Streptococcus per .100 ml `COST PROBABLE NUMBEP. TECHNIQUE. (MPN) Total Coliform: MPN Index Der 100.ml — Fecal Coliform: MPN Index per 100 ml OTHER ANALYSES THESE RESULTS INDICATE THAT THE WATER SAMPLE,, WAS (WAS NOT) (NOT APPLICABLE) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO-THE NEW YORK STATE DRINKING WATER STANDARDS, FOR THE PARAMETERS TESTED,. AT THE TIME OF. COLLECTION. Albert H. Padovani, M.T. ASCP), Director LEGEND RDS • Recommend Disinfect- ing Water Source < less than TRTC a Too Numerous Too _ Count 7 0le,� 00 29 O 56 N� 0 ua �o O NOTE: ON 0 N T3 %p 0 va O O; 6 3.208 AC. O O FRAME DWELLING 0, (UNDER CONSTRUCT I k- WELL O Od 22A. -54" co KE �P GF T� <�r av o�s F REFER TO MAP TITLED, "FINAL PLAT SHOWING QUAKER RIDGE ESTATES, R -40 ZONE TOWN OF.PATTERSON, PUTNAM COUNTY, NEW YORK,. SCALE: I" =100 TOTAL AREA: 61,978 DATED: JAN. 24, 1984 REVISED THRU APRIL. 5, 1984 ' FROM THIS OFFICE. P s 3 ;! / pl5T bX T L6Vp/, okJ CONC. FT(,. ec-A4 l F(ZLSf M PT" p'I�G�AK6� FIOtJS�{ Wl�li. �OCAT;arJS t5 P�F2 Sd5Ne;Y TUi TE C)A -reP 11- 21-8m I V'2 I l ►1 I L,oc,Arl o tJ S i2F� 6AL MA -Af,JZY SEPTIG TA1�1= Wk 1 5 D CMeTAVQ piZAltl 1 3' C. O, FtUt, cn I 1 1 T. L'V %5 -O" rutnam County Department or Healtni2r,�O (oAL, Ri sc-k Trtc- TMY-- tvision of Environmental Health 3ervi f7B !iF � �4 ' . 7 -F- H '2 199 - 9 'q'q 3 --f- !04 '- 9' S0'- 0" 3LIIL7 SE?iIG S`(5 P-k\ 1Z� ��T)- � F0 2 �!�TGHC� hUN�6� i;,; .., ... , ...... , u7 129 -O ,4 -7 I l ►1 I KEG 'P i2F� 6AL MA -Af,JZY SEPTIG TA1�1= (vto8 LF (a 24" 'K21�1GH 1 5 D CMeTAVQ piZAltl 1 3' C. O, FtUt, cn I 1 1 I NsTA,I.ED 1 I j 1 1 oI -QI �1 rutnam County Department or Healtni2r,�O (oAL, Ri sc-k Trtc- TMY-- tvision of Environmental Health 3ervi f7B !iF � �4 ' . 7 -F- H al j)roved as noted for eonformanoe piths' DftP CUFITAtt� DP.Ajr 3' 2.0.3 F1�1 :"ylioable Rules and Regulations of the i Anam County Health Department., 3LIIL7 SE?iIG S`(5 P-k\ 1Z� ��T)- � F0 2 �!�TGHC� hUN�6� i;,; .., ... , ...... , J. rt ,1 ;, ,. TM t, FMa t_1;1..1'1'11. (;`. 4-1 ;.. .".,: \• ^. .i'�!i "I "!I:'•, !' !'i i!. LOT QuA<a(Z F-vD Pi FiSTATPj \CAS iN,"i"'r iiv h T!!' is '•1,; k'i ', .tl !1 (1, i.R to OUA TO 5OX u13 S N F rW FUY is . KI I.13 -R9