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HomeMy WebLinkAbout0447DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 13.07 -1 -13 ' 00256 his i 6 - l LIZ 00256 .... - .. ,� ram .-- .- .- .r•,- ..- csx'+,- � -..:. a.-- �;.- �t,,..,-^. a-.--°-- s-^ ��' r-x�^- �,:r- .y'r".�-- ?''•R. —'�,- ."'"'; -, Irv'•- •""i^� --�-_ - PUTNAM COUNTY DEPAMMIENT OF HEALTH �1 i Division of Envhoameetal Ream Carmel, N.Y 10$12 `� d' Eoglneer Mart Provide ' P C H D Permit CERrM TE: 0 CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM , Q. qq owe .. Located at Tar Map 'h Block Owner /applicant, Name Formerly Snbdlvlslon Name ' - MaWng Addeare 7Ap % Tom Subdv. LOt � Fee Enciosed Amount Date. Permit 'Issued. Separate Sewerage System built by gf r 1 Address Consisting of Gallon Septic Talk and sh�T- Water Supplyl. Public Supply. From Address on Private Supply Drilled by AY Address IA .. A w AN hsv Bulld!ngType LOt Size ":,,"F HBS Erosion Cnntrnl Rua_ (`n nl.eted? T 9 Number of s Has Garbage; Grindei Been lushdledt Otber.Requirementr I certify that the system(s) as liaLed serving the above premises, were cted essentially as shown the plans of the.completed work ( copie s of which are attached), and in.:accordance with the standards; rdles.and're coma itions, in a cordarice withAA filed. an, and the permit issued by the Putnam County Department /O1f, Health. XV Oats I �/ Certified. by I P.E. RA. Addrau D Lipna NO. � Any pawn occupyirq promises saved by the above systems) shall promptly -take such action as'eitsy be nmossssry'to secure the correction of any unsanitary conditions resulting. from such uses. - Approval of' the upaii sewer system shall become null' and void as soon as a p4w.: unitary www becomes available and the approval of the private water supply shall become nut kt when 'a p` Ik wat4i supply becomes avallable. Such approvals are subject to modification or change . when, in the Judgment of the C i na tii, ch rev* atbn, Ifkat)on or change Is necessary. 3/89 oa.l�'-''3 4- WLLL UUrlrLLiiUN ccLrvnr * * DEPARTMENT OF HEALTH Division Of Environmental Health Services PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only WELL LOCATION STREET AOURESS: TOWN/ VI ! 1 I Y TAX GRID NUMBE Pan Rd. Patterson, NY WELL OWNER' NAME: ADDRESS:. Shay Homes, PO Box 619, North Salem, NY 10560 Q PB/VATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary -a RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM ❑ TEST /OBSERVATION O OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION []ADDITIONAL SUPPLY ®NEW SUPPLY (NEW DWELLING) ❑DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH 605 ft. STATIC WATER LEVEL —wit. DATE MEASURED 10/11193 DRILLING EQUIPMENT ROTARY ® COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE O SCREENED ❑ OPEN END CASING fCkOPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENGTH _ __U—ft MATERIALS: ® STEEL ❑ PLASTIC O OTHER CASING LENGTH BELOW GRADE 30 - ft. JOINTS: ❑ WELDED ® THREADED O OTHER DETAILS pIAMETER. 6 in.. SEAL: IRCEMENT GROUT 0 BENTONITE ❑OTHER, WEIGHT PER FOOT lb./ft. I DRIVE SHOE ❑ YES O NLT LINER: Q YES O NO SCREEN DETAILS DIAMETER (in) 'SLOT SIZE LENGTH (It) DEPTH TO SCREEN (It) DEVELOPED? FIRST OYES ONO .HOURS SECOND GRAVEL PACK O YES ❑ NO GRAVEL SIZE: DIAMETER OF PACK in_ TOP DEPT}{ ft. BOTTOM DEPTH h. WELL YIELD TEST If detailed pumping tests were done is in- METHOD: ❑ PUMPED t t �CkCOMPRESSED AIR , formation attached? O BAILED O OTHER C3 YES O NO y�lELL LOG If more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE Water Bear. Ing Well 013" meter FORMATION DESCRIPTION code It. (t, .WELL DEPTH It. DURATION hr. min. DRAWOOWN It. YIELD 9Cm. Surface 14 Drilling n in overburden clay. & boulders Hit t o ck at 141 6 540 14 31 Dr illing in rock set casing grou ed 31 605 Drill ng in rock granite. 10 19 93 Hydrofracked Well WATER O CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO STORAGE TANK: TYPE WellXtrol #250 CAPACITY 44 GAT,. PUMP INFORMATION TYPE submersible CAPACITY 5 g MAKER Gould EPTH 560' MODEL 5ES10412 VOLTAGE 3-3OHP I _ WELL ORILLFA NAME T.F. 13—e5=--S`ons,1nc. p 4 Putnam A /29/93 Ave. ADDRESS SIGNATURE Brewster, NY 10509 .t/ tsv A, Building Constructed by I,ocation Street kl !Municipality Building Type Subdivision Name Subdivision Lot # GUARANTEE 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 Environmental 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 % day of W, 19 9.3 Signature Title i rtC . Contr ctor ( ) - Signature / 4 d r Corpo tion Name (if Corp.) Address rev. 9/85 mk l� NORTH AMERICAN LABORATORIES, INC. ANALYSIS. DATA SHEET . _ TYPE: PW - ... . LOCATION:. John Shay "Shay. Homes" REPORT TO: P.F..Beal &.Sons, ADDRESS: 4 Putnam,.Ave. CITY,.STATE, ZIP: Brewster, NY 10509. DATE COLLECTED: 11723 -93.,. :. TIME COLLECTED: 1:.45 AM . COLLECTED BY:' PF Beal .REPORT .DATE.: 11 =29 -93 LAB # : .93 =6228 .SAMPLE SOURCE: Pan..Rd.., Patterson,. NY DATE ANALYSIS RESULT. UNITS. METHOD ....ANALYZED Total Coliform MF Absent /100mL' SM.17 (9215D)11 -23 -93 THIS SAMPLE AS RECEIVED AT THIS .LABORATORY MET THE REQUIREMENTS OF NEW YORK STATE DRINKINGWATER STANDARDS. I PUITIAN1 OOgMDERAlliME MITALTH �q l Dh hOw dAmbeemosaw Hoehn Servloem: cory"L N.Y. low PaavNa Pee�lt ®C62TRRCATB OF WN lITVIQI 1102 SRWAOB DWOUL SYSII= MA .C�L P�4��12sON [- ew. or Volvo. Talt blap *5 , 0 Re* I Renewal ❑ 2erWaa' ❑ ✓l l KE F, IZOGCD Deft of pnwi a Appaoval Mew Atfiw �/4P1 1Z®�1% Town Date Subdivision Annroved 09 "f = �. Fee Enclosed A,,,.; �boo_ D 4 &Met Type K yS 1pE W—rJ 4L .-W Am i .00R Aa • t Fm s«noo o14 VOIMD Nober d Heilseom m �' Delon Flow G P D & d Q P(BD Nolmeadoe Is Repaired Wbon FBI 6 completed S"Waft sewaesve Syetm to annum of 10010 "rte Septic Tact S . Tells d by T$ �D Atllb�o. Water Sepptys PoRdc Supply hen Adhoeg an 1._M r e Sites Dd led by :MV wilt., Od w> •e p 2' 1 L L I represent that 1 am wholly and completely rasponsitile for the design and location of the. proposed 'system(s); 1) that the separate few di al f stem above described will be constructed d at shown'on the approved amendment there •to_ and _ in accordance with the standards, rules a reou ens O nom County Depwtment Of MeeRh, and that on,completion thereof a * Certificat* of Construction Compliance" setisfadory to the Commissioner of Mealthwlll be submitted to the Department, and r written guarantee will be furnished the owner, his successors, he" or assigns by the builder, that aid builder will peace in food .operatbq condition. any port of -ald fawafa disposal' system during the Period of two'(2) years immediately following thedato at the iqu- ana of the approval of the Certificate of Construction C "PI original system or any' *pairs tneret ; 2) that the drilled well described a6ow will be located as shoasm'on the approved plan and Shat aid well w 1140 InstalNO n a nab with the radar rules and r ns Of 'the Putnam County Department Of MMRh. �[ Oats p ,p ,iSigned 1� p.E.r_L+_� [�R 1A. - Addr�g L'J Y/t I 1 \�l G �. G SQ License NO 4;2 / 2J 1 APPROVED FOR CONSTRUCTION: This approval expires "two years from the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended 0i modified when considered necessary by the Commissioner of Health. Any change or alteration of construction r*euir a w perm Approved for disposal of domesti sanitary ssWif�7rid fivate wat� only. I.Ov88 Oates �T.r BYE 1t�o'— �--- Title -s DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT #` WELL LOCATION Street Address Town Village City Tax Grid Number A C✓Q , © — 1 WELL OWNER Name Mailing Address C,OGClJ , ffiM "Al2 fajFgS0W Q.Private D Public USE OF WELL - primary 2 - secondary Q RESIDENTIAL ❑ PUBLIC SUPPLY 0 BUSINESS ❑ FARM 0 INDUSTRIAL O INSTITUTIONAL ❑ AIR /COND /HEAT PUMP O TEST /OBSERVATION ❑ STAND -BY O ABANDONED 0 OTHER (specify O AMOUNT OF USE YIELD SOUGHT r _gpm /# PEOPLE SERVEDt) -+ /EST. OF DAILY USAGE O6 gal 13 REPLACE EXISTING SUPPLY [3 TEST/ OBSERVATION M ADDITIONAL SUPPLY Q NEW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING w4F KeS 9Ve CE WELL TYPE ®DRILLED ODRIVEN DDUG GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Gr?_j Lot No. NAME OF PUBLIC WATER SUPPLY: N /A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: 'N/A LOCATION SKETCH & SOURCES OF CONTAMINATION P (RON SEPARATE SHEET (date) (signature) 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 thirty (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 operations, 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 suc a manner as not to degrade or otherwise.c.ontaminate surface or groundwater. Date of Issue: '� 19� � Date of Exp' ation 19:] � Offici al Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller WATER WELL CONTRACTOR: Name 7Pj Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X_NO NAME OF PUBLIC WATER SUPPLY: N /A TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: 'N/A LOCATION SKETCH & SOURCES OF CONTAMINATION P (RON SEPARATE SHEET (date) (signature) 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 thirty (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 operations, 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 suc a manner as not to degrade or otherwise.c.ontaminate surface or groundwater. Date of Issue: '� 19� � Date of Exp' ation 19:] � Offici al Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH APPLICATION FOR APPROVAL OF PLANS FOR A WASTEWATER DISPOSAL SYSTEM 1:1_ Name and Address of Applicant: t,4 I K.F, 1%. t2aGC� 'FA-f- TE(K90 ICI , WY I 1r Name of Project: I Iry 5Fp SSPS 3. -.-Location T/V/C: 1P41` PR -c,04 i�4AlD0L1'I 1N• LAtJ�CEi�tT � P,� t Project Engineer: LAS ANT NCB• ASSOG. C. 5. Address: -1J P KfEIBLD UYL P/k-s- TeKSONk f N� I Z�103 License Number: :15130 Phone: Ii S. Type of Project: Private /Residential Food - Service • - .Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject to State Environmental Quality Review (SEOR)? Type Status .(Check One) Type I.. Exempt Type-11 _- ,t 1.J sted 8. Is a Draft Environmental Impact Statement (DEIS) required? ............. 9. Has DEIS been completed and found acceptable by Lead Agency? ........... _ a 10. Name of Lead Agency /A 11. Is this project in an area under the control of -local planning, Zoning, or other officials, ordinances? ........................................ NO 12. If so, have plans been submitted to such authorities? .................. N 13. Has preliminary approval' been granted by such authorities? H Date Grantpd.,. 14. Type of Sewage Disposal_ System Discharge...... Surface Water _Ground Waters 15. If surface water discharge, what is the stream class designation ?........ 16. Waters index number (surface) ............................................. 17. Is project located near a public water supply system? .................. N d 18. If yes, name of water supply N A Distance to water supply — 19. Is project site near a public sewage collection or disposal system ?..... t4 D 20. Name of sewage system 1.1 15 Distance to sewage system J21. Date observed: ONKNOWN► 23. Name of Health Inspector: 0r1KN0WN 24. Project design flow (gallons per day) ...... ............................... CoD D 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?.. 14 0 26. Has SPDES Application been submitted to local DEC Office? ............... Nlh► 27. Is any portion of this project located within a designated Town or State wetland ?...... .........: ............. ............................... 40 28. Wetland ID Number ........................................................ _� A 29. Is Wetland Permit- required? .............. ............................... 1�0 Has application been made to Town or Local DEC Office? .................. 30. Does project require a.DEC Stream Disturbance Permit? .................... 1� b 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal,''. " landfilling, sludge application or industrial activity? ........ YES or NO No 32. Is project located within 1,000 feet of existence of abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potential known source of contamination? ..............YES or NO N 0 DESCRIBE: 33. Is there a local master plan or file with the Town or Village? ........... S 34. Are community water, sewer facilities planned to be developed within 15 years? t4 35. Are any sewage disposal areas in excess of 15% slope? ........................ �0 36. Tax Map ID Number ......................... ............................... 13 - .01 i 1 37. Approved Plans are to be returned to: Applicant _� Engineer Zf the application is signed by a person other than the applicant shown in Item 1, the application must be accompanied by a Letter of Authorization. Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statements made herein are punishable as a Class A Misdemeanor pursuant to Section 210.45 of the Penal Law. - - -- - SIGNATURES & OFFICIAL TITLES: .. MAILING ADDRESS: Z,-7' •:_At►,h�l..D of <� 3 PCMUM CCUM DIEPAR'T.�2Tr OF aEALTH DIVISION OF ENIVIRCWENIAL HEALTH SERVICES DESIGN DATA SHEET-SUBSUFACE SEWP=E DISPOSAL SYSTEM F= 'NO. Owner PAdress L-2, 'Located at (Street). Sec. 1�,Oj Block Jot (indicate neg-e—st cross stre--E-)- ,,=icirality Watershed e- go-To N SOTL PERCOLATION = DAM PSW= TO BEE SU&4I= W= APPL-ICATICNS Date of Pre-Scaking %0 Date of Percolation Test 2a - HOLE NuNff -U:-R C1= TII2 PERCOLATION PERCOLATION Run Elapse Depth to Water From Water Level No, T� Ground Surface In Inches Soil Rate Start Stop Min. Staxt Stop Drop In Min/in Drop Inches Inches Inches 4 9-1 T 1� - J 2 3 0 2 4. 3 5 —4 5 2* 3. /3 T4- 4 5 2 3 —4 5 NOIES: Tests to be repeated: at same depth until approximately equal I soil rates are'obtaihed.at each percolation test hole.• All data to' be suhmitUd for review.....-.. 2.- Depth measureTents to be made'fra-a top of bole. rev. 9/85. 7 11�1, TEST PIT DATA REQUIRED TO BE SUBMITTED W= APPLICATION DESCRIPTION OF SOILS ENC OUN MED IN TEST HOLES DEPTH HOLE NO HOLE NO. HOLE NO. G.L. 1' �M 2' 3' LAS Lam• M 4' 5' 6' 1 Nli'Ere�l1 o0c-, r✓- -d �� 71 8' 9' 10' 11' 12'.. 14,.•. . INDICkTE LEVEL AT jYaim GROUNIXqA� IS ENCOUNTERED INDICATE LEVEL TO WHICH 1�MER LEVEL RISES A.FTEFt BEING ENCOUNTERED DEEP 'HOLE OBSERVATIONS MADE BY: 0 N K 0 W IV DATE: 1 r`I KJ40 W DESICN Soil Rate Used -ID Flin/1" Drop: S.D. Usable Area Provided No. of Bedroans 5 Septic Tank Capacity 1000 gals . • Type CegN6,, Absorption Area Provided By L.F. x 24" width trench Other 2 ' F i I _i Nan-p-__. LA N'` N cs55a� , , EC, . Signature Address SEAL � Q °•��_• • �� m � y 4i w.' N V� o. 045781 �2 A9�Fess►A�P� THIS SPACE FUR USE k4i,- ALTH DEPARTMEN ONLY: -` Soil Rate Approved sq.ft /gal. Checked by. Date m 9 DEPTH HOLE NO HOLE NO. HOLE NO. G.L. 1' �M 2' 3' LAS Lam• M 4' 5' 6' 1 Nli'Ere�l1 o0c-, r✓- -d �� 71 8' 9' 10' 11' 12'.. 14,.•. . INDICkTE LEVEL AT jYaim GROUNIXqA� IS ENCOUNTERED INDICATE LEVEL TO WHICH 1�MER LEVEL RISES A.FTEFt BEING ENCOUNTERED DEEP 'HOLE OBSERVATIONS MADE BY: 0 N K 0 W IV DATE: 1 r`I KJ40 W DESICN Soil Rate Used -ID Flin/1" Drop: S.D. Usable Area Provided No. of Bedroans 5 Septic Tank Capacity 1000 gals . • Type CegN6,, Absorption Area Provided By L.F. x 24" width trench Other 2 ' F i I _i Nan-p-__. LA N'` N cs55a� , , EC, . Signature Address SEAL � Q °•��_• • �� m � y 4i w.' N V� o. 045781 �2 A9�Fess►A�P� THIS SPACE FUR USE k4i,- ALTH DEPARTMEN ONLY: -` Soil Rate Approved sq.ft /gal. Checked by. Date m . I s- PUTNAM COUNTY DEPARTMENT'OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of ��E'_ f . K V e cr, b Located at FawA_Roct (T) F94e_irro "yk- Section /� , Q ? Block Lot f �J Subdivision of Subdv. Lot # r Filed Map # _Date io -.2<p.1 Gentlemen: This letter is to authorize to h /01 I-AU _/_ a duly licensed professional engineer or registered architect (Indicate) to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules. or regulations as_.promulagated by the Commissioner of the Putnam.County Department of Health, and to sign all necessary 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. Countersi�'ned: P.E. a B5W., #_ /per NE� W ILL /q,� �- Q-o� �C �oFESSwNi 3�� rye /C/ A-1 -V Address PCY§e4g-r.1-' , I'1 ly Telephone Very truly yours, Signed K Owner of Property Address ) Town Telephone I; et ,T R. b f BRUCE R. FOLEY, R.S. Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 August 30, 1996 (914) 278 -6130 Michael & Ann Marie Rocco Pan Road Patterson, NY 12563 Re: Addition - Rocco pan Road No increase in number of bedrooms TM #13.7 -1 -13 DearMr. & Mrs. Rocco: 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 latest revision date of August 30, 1996 and this Department's approval stamp. Based on the information .submitted, the above mentioned addition is approved with the following conditions: 1. The total number of bedrooms must. remain at 3 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. WH /jp cc: FIT (T) Patterson Very truly yours, William Hedges Sr. Public Health Sanitarian FT a A W�- (i - 0111 P", "17; g'. Lj ,,, �4. � � t • ;�� � �G��'M� r,�,a�. ►NC, � � :. '.1 j � : i I ; _ �; 1 � E :� � .j 4. i AU444 o 0 7" -7 4 CIUBLZ ruznam County Department Of 90alth" tt AvIsion 2 of EhViroomental. Health K.O. , Approved Le noted for confOrmancO witb Applicab-le Rules and RegulatiOnS"Of..tho E�ent -utna_ ..... r4NCiiEN tune 64 Title L & -7ft—I LO-1 /"-I I I CJO IL. W(Wnt4 00 NJI 44 - w'A r- � f�ih,1 P,�°6�'�'r'�°'�ts - ttEP4i1"1G' ti` 40 or. VA"04 AW ts 6*40'" -14 Et�T s c DiM>%N�tON G4- I�Iz"f (IU �1.) THIS 16 TO CERTIFY THAT THE SEWAGE D6P05AL. SYSTEM WA5 CONSTRUCTED AS INDICATED ON T1416 PLAN AND THAT THE SYSTEM WAS INSMCTED 8Y ME 6EFOKF- IT WA5 COVEKED OVER . THE SYSTEM WAS CONSTRUCTED IN ACWI?PANGE WITH ALL STANDAIM RULES AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AKID THE NEW YORK STATE DEPARTMENT OF HEALTH . NO (E HOU'iE 4 Wt%I L t OGA11oN6 t3AhED ON ° SV fzvr--{ Oj° t'I�OPGizTY° F(tEPA1LEn ni( TG(1{zY {�C�d,CNno�� GOU,IUS, kL,6. t 00.o I�.o �' . �G•5 10.0 5 02.5 1b.5 � 81.h 82.5 1 q3.5 BB.� B qq.5 q5.o THIS 16 TO CERTIFY THAT THE SEWAGE D6P05AL. SYSTEM WA5 CONSTRUCTED AS INDICATED ON T1416 PLAN AND THAT THE SYSTEM WAS INSMCTED 8Y ME 6EFOKF- IT WA5 COVEKED OVER . THE SYSTEM WAS CONSTRUCTED IN ACWI?PANGE WITH ALL STANDAIM RULES AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTH AKID THE NEW YORK STATE DEPARTMENT OF HEALTH . NO (E HOU'iE 4 Wt%I L t OGA11oN6 t3AhED ON ° SV fzvr--{ Oj° t'I�OPGizTY° F(tEPA1LEn ni( TG(1{zY {�C�d,CNno�� GOU,IUS, kL,6. �BZ _,VQ2595oe C/ 4f*. t, f AN r-e9AP ruzuam Uounty Department ox tiealti. jivieion of Environmental Health Service - ipproved as noted for conformance with ,pplicable Ifulee and Regulations of the 'u a County, Health Department., q 119n0.tUTA E T1 A L. SITE LOCATION PLA SGa LE : C : 2000 PZOF°ERTY SHOWN ON TOWN OF FA Tr -_K5ON TAX MAP : 13.01- 1.13 I r, 1 t j Iil r j�l PROJECT PROPOSED SSDS - P?�T"f CLIENT 111 r—f. fo, 1,20,00 PaN t"OAV LAURENT ENGINEER ASSOCIATES, P.0 MILLBROOKE OFFICE CENTR Route 22 & Milltown Road Brewster, New York 10509 (914)278.6108 - (FAX)•278 -2658 CONSULTING SITE ENGINE DRAWING TITLE AS -BUILT PLAN SCALE IV s W, DATE 12_ 1 _a P10 <v DRAWN BY ITV"( 1h� CHECKED BY HWW 2' FV sr 34' -0" E i A �. TO CONN. W/ 3' M.VENT LAV wr. I AV wr. EPA 54--0- z z J up -t n. BDRM #3 : v 1 1 2 D i LAV 7 v - z w z . 7 MBDRM #1 BDRM #2 TO CONN. W/ 3' M.VENT LAV wr. I AV wr. EPA CERTIFICATE OF OCCUPANCY AND COMPLIANCE . . . . . . . . . . . . zotun of 'afterson, .......... 19 93 DATE ISSUED December 1, THIS IS TO CERTIFY THAT Shay Homes, Inc. ON THE PROPERTY OF Michael Rocco LOCATED ON- Pan Road HAS BEEN SUBSTANTIALLY CONSTRUCTED TO THE REQUIREMENTS OF THE BUILDING CODE, ZONING ORDINANCE AND LOCAL LAWS OF THE TOWN OF PATTERSON, NEW YORK AND MAY BE OCCUPIED AND USED AS Single Family Dwelling with Wood Deck Building Permit Dated Permit No. ...19.45.. Application No. ...1197 ............ SECTION ...... 1 ................ BLOCK ......... 7 .............. LOT ....... 7...1 .... (New, TM - 13.7-1-13) FEE $ 15.00 BUILDING INSPECTOR