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22.84 -2 -1
BOX 7
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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
April 7, 2003
Stephen & Lynn Hill
77 Echo Rd.
Carmel, NY 10512
Re:Addition -Hill, Echo Rd.
No Increase in Number of Bedrooms
(T)Patterson, TM #22.84 -2 -1
Dear Mr. & Mrs. Hill:
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 April 7, 2003 The addition is approved with the following conditions:
1. The total number of bedrooms must remain at three 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 y ,
William Hedges
WH:lm Senior Public Health Sanitarian
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PUTNAIM .COUldiY HEALTH.DEPT. 025320
1 Geneva Road (845)278 -6130
Brewster, NY 10509 Date�Q3
Received of _
The Sum Of _ ®� . 96�cvr, cGu.�- patio Dollars $ /0 0, O U
For�y�� 3
eo THANK YOU!
❑ Cash ❑ Check (TVI.O. O Credit Card gy/�cJ
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' Preschool (845) 278 -6082 Fax (845) 278 - 6648.
ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET �% ���� �I TOWN )-2,1� fcz_so:J:: TX MAP #_a� y "'
NAME ej_) A L�(,r PHONB(S(yS7 -'--�o-ILY %1PCHD#_
MAILING. ADDRESS % = �b �dI Ca,-� eL1y1%
DESCRIPTION OF ADDITION 9,6 ), )ej
NUMBER OF EXISTING BEDROOMS j PROPOSED # OF BEDROOMS_
(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 S100.00..
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
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
BFhouseguideEnes
RUCE R FOLEY
blic Neclth Director
LORETTA MOLINARI R.N., 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
Re:
Residence
Tax Man q ' t: -4
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
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PUTNAM COUNTY DEPARTMENT, OF HEALTH
Dn% /sign of ,Enwronmenfs/ Hale /t/i, Sen!ifaea, same% N ; 'Y_ .;1Q612 permit /!
CERTIFICATE• OF:"CONSTRUCTION COMPLIANCE FOR _SEWAGE -DISPOSAL SYSTEM
LOCated..at �'^�r�o aiai�Map : Block w
n or V(Ilags
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Owner �`�Y �LR�� I�•�
Formerly Tax Map Loot�I♦.._,�- .. �Subd Lot
Separate `Sewerage System, built by � � IVY Address . t . _ •- ����R/ ��
Consisting , of . OaI: r Septic "Tank and
Other requirements ' S
Water Supply- Public Supply From
Private $uDDly Grilled By,
Address
Building Type ._�� �d _ No, of ,Bedrooms Date Permit IsweOu�'�!c,
Has Erosion' Control ,Been, Completed?`
I certify that the systems) as.liated 'serving the.above premises were constructed essentially as shown on the plans of the completed work ( copies
of which are attached), and im accordance with the standards, rules and regulations, in accordance with the filed plan,'and'the' permit issued by the
Putnam County Department. Of Health.
-
Gate. Certified by P.E. R.A '
Address 5 icense No
C „lam
Any person occupying premises served by the above systerh(s) ihall promptly take such action at may be "nocessary..to cure -the correction of any uhuriltary
conditions resulting from such usage., Approval of ,the separate sewerage system'shall become null and void as soon as a public unitary ,.sewer becomes
available and the approval of'the, private"wgter supply shall become null and void when a'.public Wa ply becomes available. Such approvals are
subjeet,to modification or chant's when,,, n.tha judgment `of tho Co siorr.of,Health, such r ocatfo ,modification orchange is necessary, '
i
Date
Rev. 9 -81 -
m
Owner or urc aser o Building
Building Constructed by
Location - Street
Municipality
Building Type
Section
Block
Lot
Subdivision Name
Subdv. Lot #
GUARANTEE OF SEPARATE SEWAGE 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 success-
ors, 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 initial use of 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 occu-
pant of the building utilizing the system.
The undersigned further agrees to accept as conclusive the determin-
ation of.the Director of the Division of Environmental Health Services
of the Putnam County Department of Health as to whether or not the fail-
ure of the system to operate was caused by the willful or ligent act
of the occupant of the building utilizing the system. �.
Dated this day of 19 Signatur
Title V/C6.
/,vC,4�
Corporatio Name (if corp.)
ddress
__________________ ____fir___
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PL S BEFORE
CERTIFICATE OF COMPLETION WILL BE ISSUED.
GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM.
Division of Environmental Health Services, Putnam County Department of Health
a
n,
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES —
COUNTY OFFICE BUILDING, CARMEL, N. Y. T0512 ......
.DESIGN DATA SHEET-
.. .. _ . .....� ,......i ............._ .....
Owner
TE SEWAGE ]
ss
FILE NO.
Located at (Street dic eI •Sec. Block Lot
neare cross street)
Municipality-," _ -. ..- _...___......___.._.... -. Watershed Q
SOIL PERCOLATION TEST DATA -- REQUIRED TO BE SUBMITTED WITH APPLICATIONS
'Hole
Number CLOCK TIME PERCOLATION._ -r.:. _.,.._.... PERCOLATION
Run . apse.
_. . . . p Gro o una d eSur water
rface a ri e r Level
. ........ Inches
_Soil Rate .No....__... Time
Start -Stop Min. Start Stop Drop in Min. /in drop
... .._ ............._. _..........._. _. _...._ ...... - Inches . _ ...._
_.., ..__._..._.Inches....___ Inches � -�
2
3 fi _ f�
_-
2
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.
DEPTH
G.L.
m
TEST PIT DATA REQUIRED-TO BE SUBMITTED WITH APPLICATION
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
HOLE N0. HOLE NO HOLE NO.
. - Ll"D1171V
Soil ._Rat e_.,Used Mirk l "Drop.::,.__..,...�..- .._ S,D,._Usable._ Area Proyide.
No of.Bedrooms
Sept.c :Tank _Capacity �� Gals.• ._........Type
Absorption Area Pr— o ded By w.Ldth Trench.
T
f....:,h;PA /4, /
Address .. 6 ... _.....__...SEAL _.. _......_..:, .. -- .._....... ...
.....THIS...SPACE -FOR .USE..,BY__HEA.LTH _DEPARTI! ENT_ ONLY:_ ..._.._.... . ...... ..... :`.._.._._ _.. .
Soil .Approved Sq._,_Ft /Ga .o,.,.__.._ ;..Checked .by Date
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Putnam County Department of Jiealttk
division of Environmental Realth Services
Approved as noted for conformance with
applicable Rules and Regulations of the
County th Department.
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Putnam County Department of Jiealttk
division of Environmental Realth Services
Approved as noted for conformance with
applicable Rules and Regulations of the
County th Department.
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WELL COMPLETION REPORT
3/71
----
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services
COUNTY OFFICE BUILDING - CARMEL, NEW YORK
This report is to be completed by well driller and submitted to County Health Department together with laboratory report of
analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued.
REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION
OWNER
NAME
McGlasson Builders
ADDRESS
Gleneida Ave. Carmel
LOCATION
OF WELL
(No. d Street) (Town) (Lot Number)
Echo Road Carmel
PROPOSED
USE OF
WELL
BUSINESS
DOMESTIC ❑ ESTABLISHMENT ISHMENT ❑ ❑ TEST WELL
FARM
❑ SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING OTHER
)
DRILLING EQUIPMENT
THER
❑ ROTARY � A COMPRESSED IR PERCUSSION El P PERCUSSION ❑ (specify)
CASING
DETAILS
LENGTH ( /set)
rj 2
DIAMETER ( Inches)
6
WEIGHT PER FOOT
19
THREADED ❑ WELDED
x YES ❑ NO
I
ES NO
YIELD
TEST
HOURS G.P.M.
❑ BAILED ❑ PUMPED COMPRESSED AIR
YIELD (G.P.M.)
8
WATER
LEVEL
MEASURE FROM LAND SURFACE — STATIC(Speclfyteet)
DURING YIELD TEST [feet)
i
Otal Drawdown
Depth of Completed Well
in feet below Land surface: 300
SCREEN
DETAILS
MAKE
=(Inches)
LENGTH OPEN TO AQUIFER (lest)
SLOT SIZE
DIAMETER (Inches)
IF GRAVEL
PACKED:
Diameter of well including
gravel pack (inches):
GRAVEL SIZE
FROM (feet)
TO (feet)
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION
Sketch exact location dm of well with distances, To at least
two Permanent t landmarks.
FEET to FEET
0
40
Overburden
40
300
Ledge
If yield was tested at different depths during drilling, list below
FEET
GALLONS PER MINUTE
DATE WELL COMPLETED
9/21/83
DA E OF P RT
16712 8 �
WELL DRILLER (Signature)