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HomeMy WebLinkAbout0629DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23. -2 -58 BOX 7 11• SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J.BONDI County Executive [IT MORRIS, PE Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road.. Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY STREET �2. % ./�"s1�OWN TAX MAP # , °02'�� NAME Z�.PHONE Of PCHD# - p MAILING / ,. �rG � DESCRIPT ADDITION NUMBER OF EIISTING BEDROOMS — v41 PROPOSED i( OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CERTIFICATION IFICATION 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, to be shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin HA -1) 3, Two sets of proposed floor.plans (drawn to scale with name, street and tax map #). *. Nori- professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) 4.. Copy of survey, 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.. 5. Copy of Certificate of Occupancy from the Town or Certification from the, Building Department with legal bedroom count of dwelling. OFFICE USE COMMENTS� / f l�C_ �i�l l jG: S T j , , �f tvg' Zvi 5 Environmental Health (845 278 =613) Fax ($45).278-7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278,6026 . Nursing.Home Care Fax (845) 278 -6085 WIC (845) 27 &6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 SHERLITA AMLER, Mp, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive. ,ROBERT MORRIS, PE. Director of Environmental Health . DEPARTMENT OF HEALTH I Geneva Road. Brewster, New York 10509 Town Legal Bedroom Count &.Proposed Addition Status. Re: (Owner's Name) Tax Map. # Address: �� /G►y %! G�% Y Town: Year Built: 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: The plans for the proposed. addition are considered: New Construction Addition to existin g Y house use-only Teardown and /or re =build allowed„ under Town Regulations zzz Building _Date. 6. 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 . Nursing Home Care Fax (845) 278 -6085 . WIC (845) 278 -6678 Early Intervention % Preschool (845) 2282847 Fax (845) 225=1580 1' Sherlita Amler, MD, MS, FAAP Commissioner of Health Robert Morris, PE Director of Environmental Health Lynn Kirchner 567 Farm to Market Road Brewster, NY 10509 Dear Ms. Kirchner: Department of Health 1 Geneva Road, Brewster, NY 10509 April 30, 2010 Re: Addition- Approval — Kirchner No Increase in Number of Bedrooms 567 Farm to Market Road (T) Patterson, T.M. # 23. -2 -58 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 the Department dated April 30, 2010. The addition is approved with the following conditions: 1. The total number of bedrooms in the main house must remain at four without prior approval by this Department. 2. The total number of bedrooms in the apartment must remain at one without prior approval by this Department. 3. The area of the existing sewage disposal systems, and their expansion areas, 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 proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals. 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. joseR ect fully, ph S. Paravati, Jr., PE Assistant Public Health Engineer JSP:kly cc: BI, (T) Patterson 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) 178 -6026 Nursing / Home Care Agency (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 4L feet -v, 46 PUTNAM COUNTY DEI'Alffl�IIENT 'F HEALTH PLANS APPROVED FOR BEDROOM COUNT ONLY, BEDRO-OMS A c T BSEQUENT PAEVISION11ALTERATIONS TO THESE HOUSE ILIT, s " 1, -' PIANS 1lU5T-11E SUBMITTED TO THE PCDOH FOR APPROVAL 1'E TNAM COUNTY DEPARTMENT OF IiEALTIl PLANS :APPROVED FOR BEDROOIM COUNT ONLY, Rmf..!i\`1'O -THE USE r'l,AXSN?fUST BE SUi3�°.tITTED TO THE PCDDH FOR, APPROVAL .r"`� ®m PUTNAM COUNTY DEPARTMENT OF HEALTH � i# YUSE PL. NS APPROVED FOR BEDROOM COUNT ONLY, BE BOOMS, F; � . ;, j � i3SFQUENT IIEVI�\,L',lAT'T'F'R ATiC�N� Tn Tu�sr__x�[.� I`u tiiwS IMUST BE SUBMITTED O 'A"HE PCDOH FOR APPROVAL boom- dW m d� ............ s �.... -_ t fi 'r' 1. Y�.. . ��. l m L r } N � -� :�� E fr�. t f i .. ,; ��. o -, Office of Building Inspector TOWN OF PATTERSON PUTNAM COUNTY, N. Y. TRinity 8.6500 APPLICATION FOR BUILDING PERMIT ,fig :' • `. f,. Date —1-2- __, 19�`_ L Building Permit No. Application No. Zone District Variance.Case No. Application is hereby made, to erect ( ) alter ( ) remove ( ) repair.( ) demolish ( ) addition pursuant to the New York State Building Construction Code. Location of Premises — Street or Road Tax Map Number --Frontage I ` % -� Depth Rear = = Y E ; DWNMER - -- t_: 'av-_ '`t�__� t— ADDRESIS RHONE No.e Name of Contractor. A' -1 _ ; i ;.t. � iw — ADDRESS � :1r ? ; � � ��';' � <: 1 �'.? PHONE No. Plumbing Contractor's Putnam County License No. Electrical Contractor's Putnam County License No. Use: EXISTING — r' - r =+ -_ -- PROPOSED No bulding shall be occupied or used in whole or i'ii' part for any purpose whatever until an application is made for and a Certificate of Occupancy shall have been ,granted by the Building Inspector. PLOT DIAGRAM DIMENSION OF BUILDING', FNDTNS. Stories BASEMENT Existing Construction' Proposed INT91tIOR: With- Add. ADDITIONS _ Stone Part , Wood Rooms Rooms Concrete Full Steel Apts. Porch Blocks Cement Floor Brick ^� No. Baths Garage Brick Flnished _i Concrete Bedrooms I Bath Garage Stone PLOT DIAGRAM DIMENSION OF BUILDING', Width Depth Stories :. x. x Existing x x Proposed X x With- Add. Estimated Cost ........ Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set -back dimensions from property lines. Show street names and indicate whether interior or corner lot. Application Fee -- < — This application must be accompanied by two sets of complete plans and specifications and all information .required by the Zoning Ordinance and such additional information as may be requested by the Building Inspector. I, `'.:..° rI- I `�. _L', i the applicant, do hereby certify that the above statements_ are true to ,my knowledge and belief and the proposed construction does not violate any Zoning Ordinance Law or Regulation. Total Fee $ — -- Signature of Applicants (Ovmer, Lesee, tohtractar) Receipt No. Approved '' RAert,L Aram, Jr:: Disapproved Reason _ ^_ — ...,. ' %f Building Inspector �9te.. coal. T'ttJt�� 10. ►.� :Y. 3. 4.. 40: 45 .5$ t . (A'. PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OFFICIAL USE ONLY 1 11-013 SITE LOCATION TM #3 OWNER'S NAME PHONE gLAI, MAILING ADDRESS PERSON INTERVIEWED L�A 0k-.-fA 1 PCHD Complaint # e z e ationns ip ti.e., owner, tenant, etc. DATE L-I !)L- TYPE FACILITY PROPOSED INSTALLER h�a \��. -,b�� ,«� 3,��PHONE—'9,-A:5 07 X - 0 ADDRESS 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. _ .! ,- •fi��. \ \_ __`� fie:.. c`e..�� \C`� .rte �c�� �e,��� c�� C`��c� �.:��e� =- C:..J j �C9 r . i l� \%'C� G"� �� �`L C. `fx.� A ^i f \—i C •� 1!� V \ e'er �^'� I, as owner, or reported agent of owner agree to the conditions stated on this form. SIGNATURE I TITLE DATE L 1-71 L) Proposal approve dwith 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 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 99NE ! Z �1FK DA r• - MANHVLt GVV s9o. ,• JUNCTION. BOX a 9r \�" ��. 1. 4° .I _ •"' ..:' — � :� A MNN 6 y� i t UI EV L . C- "7*�d(10. _ i S�1k('iAAY TEE $Ew'TION e kQa . �2�sme a i sEV�/c TYPICAL CONC.. ert cr�sT CaHc e4 �� 1 EIIr c. . . la►IK' TAN P B -t BIN �u SEPTIC 1C exonN s- RD LEVEL F , c ARTR .. 0ACKPILL .- i004,T -. 5�.�.IQ �.�.. PAP N S. t9'� 3v "j BLDG. ER CtIYER:` OR - HAY 2 ( _ ° PERFORATED e jJOl "k S' I) A4.L La4ac Tet" Wl�Hlu 10' OF i o A. cIPE r� B F, N $ sea{la AREA a at ¢e'�novEn. --11 E.x1Ii Id C� QOPIT:tII►I � 2� _ JUWC_-t10U Cio14T:`QO't1Nyf 25'�U1)i :a- -. - =.y CLEAN GRAVkL UR . 6 .. bEeo. -1 •CNUSHEG -STYINF -1 ~ -- eos� 'uu6.. ao A95QRPTION TRENCH a � NOTES SYS i FM TO BE CONS TRU} TEX3 IN ACtMDANCE WITH .THE RULES AND FiQGULATI0 S OF THE �yUiNAIM COUNVY DEPARTNIHNT U. FJ.61L 0. HEALTH. SY`MM:;$HALL NOT 9E BAC 'Ft14E0 ,lkN7JL WSPECTED BY D €SGN ExbjutG. \.'d EtaGtN££R AND THE LOCAL ALTH bEPARTMENT 1f: REC01M w�u. �(a Lx.P.9,N�10,>.l �� SYSTEM TO CDN_I-T OF {( "ISO "6ALlON SEPTIC -TANK'- AND..�o FT F_ f,T• TRENCH WITH A.MA.)�IMUM �XIt r.t.1G ��S k it'M PITCH' OF 1)iF4 PER FOOT. o - - DISPOSAL SYSTEM IRA O.ES FiEi.E- RENCED..TD FINI:.H£S3'FiR$T, FLOUR ELEVATION ,UNLESS::- OTHERWISE NOTED. S.S. D. SYSTEM Fury ` R SC _{. tom_.._..___" .. a ut�:?r REVlSIG-rrs IfOWlkRtd KELLY dFt, ° A$SOGIATES f N.> 39:30 °� Mu PATE 9ti' I CARMkL NEW Y H t) K 1 TAX MAP W 72 aLK -NO. . LOT NC 4 TOWN. Pt�T6RSow(/W�� / i _ i rara. G -AZ R 10 4pr: Mota001 s, 339 �r 3yo �•. _ _.. y - - _ LA }� N] � L Oi PLO .111 C k d- D 4 Ds Nrfn Hn I \ pRovoSED Poo, 15' > GLB rF IEREON SIGNIFY THAT THIS SURVEY WAS TH THE EXISTING CODE OF PRACTICE IY THE NEW YORK STATE ASSOCIATION -YORS. SAID CERTIFICATIONS SHALL RUN IDM THE SURVEY IS PREPARED AND ON COMPANY, GOVERNMENTAL AGENCY AND /OR D HEREON, AND TO THE ASSIGNEES OF THE I FI CATI ONS ARE NOT TRANSFERABL E TO Z SUBSEQUENT OWNERS. )F THIS SURVEY MAP NOT MARKEDWITH JRVEYOR'S INKED OR HIS EMBOSSED ;ED TO BE A VALI D TRUE COPY. R ADDITION TO A SURVEY MAP BEARING A SEAL IS A VIOLATION OF SECTION tHE NEW YORK STATE EDUCATION LAW. IF ANY, NOT SHOWN. cif MUL_Lr�'- \. w+ `E � 6 � - 40.3', �n / 4e N SURVEY OF PROPERTY PREPARED FOR i SITUATE IN TOWN OF COUNTY OF STATE OF NEW YORK SCALE I "=Or*' o, 6r-" Xm f kl G GEGEi I(3i I��I`ji3 CERTIFIED TO 6AP-y _`r.�T T�FZxr1 TI✓ WTOA, 1 Cojoly NA4'fio.4AL F_AN_ of c,%zMEL, • .�Ci.l�iTy TYSLE� 6J4cZta..)-y CoM�A, � �RGF' T�.O°/:�� ;URVEYORS NICHOL S G. CHAPIS, EW YORK E LICENSE N9049330 PUTNAM COUNTS „ Division of.Env�ronmental CERTIFICATE OF CONSTRUCTION+ COMPLIANCE FOR Located .at Owner E Separate sewer*,,, ,,stem: bdilltC+b�y �'+ �S CL 'L Consisting of Gal :Septic Tank _ k Other requirements, Water Supply zi Public Supply From *,p� ' r. B l �Q1 S11 A7 f Private Supply. "DF�IIed iBy `Address Budding. Type Has Erosion Control Been Completed c rt�fy,'th'at the sy'stem(s) °as +listed serving -the above premises were con attached), and m accordahce wrth the standards rulesgand regulat+on: c J � No :..of Bed►oi + /¢ ?¢ Date ? CertRied by 4� Address `} f Any person occupym9 premises servediby the above?system,(s) shall pr eonditiohs resulting from`_such rasage Approval of. the - 'separate se`v a`yailatiie' and the ,approval of the prrvate.:water supply sRallbecome,n subject to: modrficat�on or change °;when .'in the judgmerit of the 0 f AT ( orn ( - - sg S ed�work (copes of._wh`ich are' Sunty Departmentof•Health. P4E :.'• R :A. +_ o c orrectionyof any+unsanitary utihe, sanitary sewer-bei:OhMs' table .” Such - approvals are ":change' is, necessary. - ' C -OF HEALTH arine% N, aY 10512 5 a SYST;EM ` 4n'al"f"EtZSa'lJ _ �- Town .orNllage` •_YI'llG.1/ � x 1 � +1 � N`IKA� dress K.4� i71 J _ "al •Feet X ~ - � -- - width trench 7 _ _ r < II1HG� .Date Permit Issued t ( orn ( - - sg S ed�work (copes of._wh`ich are' Sunty Departmentof•Health. P4E :.'• R :A. +_ o c orrectionyof any+unsanitary utihe, sanitary sewer-bei:OhMs' table .” Such - approvals are ":change' is, necessary. - ' ET Owner or Purchaser of building Building Constructed by ,�7AR -m -Tb V_ 0 - Location,- Street o o Building Type Municipality Section GUARANTY 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 tl_A-standards, rules and regulations of the .Putnam County .Department of Health, and hereby guaranty 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 ,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 occupant of the building utilizing 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. z? Dated this day of )141- Signature Title if corporation, gife name address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS 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 i MAI Boom mommm r CONSTR UCThON (L`o'cated aY �� �SutidrvPSion, � �BuildPng Type _ �Numbei of �Bedroorr � �Weter Supply t ll T 54 (; her RequPremenfs. Date _ e K. DiVis[on of�;Enwronme% QR_ $EINAGE�lDISPOS'AL�S t y to.�be drilled by This ;approva'P expir d, or;modified:wfiert -w �r ,disposal , of?,tlomg. EPARTMENT OF HEALTH �alth: Services Carmel r Secfron =� -- - x � 'M Address S"( J, ~t` 4 ;a v a a 1 n or y lage_- Biock al °t width trench f x the separate sewage disposal system ulio arid':regulatioris o ".Y. e U barn , ?tg the.'Goinmiss over i3f IHealfhw 11 ydthe!tiuPlder` that said "buPlder•witf Iiateiy0''llowPng the date'gf the issu- hatAthe .druled well descr.;6ed above:' -and regulations .-of the Put--(W6 r Zl 1psp se, �uudPngsha`s been; "undertaken and 'is Phange�or'alterat -ion of construct,iorr PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. 1 Owner . (.� T °f SC_�� Address = 7AfL;n a AVICG- l t � Located at ( Street )' jjQ.m 7a q�ej A, Sec . '")� Block 1 Lot g- jindicate nearest cross, s reet j Municipality. �-u€esgXl Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse 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;N:� v 2 3 to'. 4o i o '. 4-1 Rio , it1 tO`.5� 'a CD 1 5 to'•sS 3 4 Notes: 1) rates are ,for review 2 Tests to be repeated at same depth until approximately equal soil obtained at each percolation test hole. All data to be submitted Depth measurements to be made from top of hole. DEPTH G.L. 6" 12" 18" 24" 301! 36" 4211 48" 54" 60" 66" 7211 78►► ►► TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRI'fTION OF SOILS ENCOUNTERED IN TEST HOLES . HOLE NO. 84 A INDICATE L AT WHICH GROUND WATER IS ENCOUNTERED INDICATE'LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY �„ Q : j- ---� C c{� Date I - L*� - 2 4' DESIGN Soil Rate Used_j_a_Min/l "Drop: S.D. Usable Area Provided S a No. of Bedrooms j Septic Tank Capacity , S Gela Type ?� Absorption Area Provided By 9� L. F. x24" oE`�� tth trench. ry< Sher Address Ali THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: e 0� ►E %^ Soil Rate Approved Sq. Ft /Gal. Checked by Date PLAN MANHOLE COVER N 3R4,' rV,.Di• 3U s _ ��JCT10N St3X _ tN.1 12 iti' � .. . ,�O ti, 4 }•MI51 t. •^ ~.i' 4�MIil. t3 MIN. .i CAST IRON -I , SE(.7l(irii 4B' SANITARY Y T t a l �t2eslrel)tf; TYPICA` CONC. 1 1' � ?R- -cast CONC. u 1auK . t>uc-fld,S SEPTIC TANK v RE IN F. a "c c. e/w 1. '+ W - a.tc,� SUQ FACE - .. 'Exo�stq df t. ORO. LEVEL '•. '. r _ 3 � _ i- .- i .r' - .. - - s-.- cARTH . P - ...... ......... ��'F. ti••�1�... BACK FILL ..-Z JOtNF B 6G. PAPER Cl -.VER' L OR HAY o / L �r:• fir„ `H' jjOj3e'4:. 1) AL LAKG6 e6cl v'TTBIU ,0' OF . E , �Q L ,.'. -- c i .. .. lIf` tit ..1 SELiG A2Cs'l To tbC 2£/•t.QV C: t�• � �' CLEAN GRAVEL OR i b, A PRQPP :g� 2 2 °edih. Ia,e._..:._. --"i r JvHC..�to>,a`450%. Fooll oG c SE'j 6E�t�•^? CROSttEC, STCME qh �,•'` bi`r *—(tfMi �. _3o FegS� uia5.: v A9v,C1RRTVOFJ- TRENCH NOTES $YSTFM TO- BE CONSTRUCTED IN ACCORDANCE WITH THE RULES AND ILYIU i��� - r tt.'rn1 RE6ULATifjNS' OF THE PU —TNAM— COUNTY DEPARTMENT w&1t7s OF HEAL -TH. _ SYSTEM SHALL NOT BE SACKFILI.10 UNTIL INSPECTED 8Y UaSIGN ENG[NEFR AND THE'tOCAL HEALTff DEPARTP,?F_NT IF k 4UIP.f_U.: T'w ltd? �XI F�.�?iJ� .. �� - SYSTEM TOCONSIST OF' A _5�?_GALLGN SEPTIC LANK AND, ao _FT EqF 3 FT, T'RE'NCH WITH A MAX4ffUM 3` `G� twxlsTlti� �`a� °t✓� R.ITCH OF 1/16 PER FOO-r. a DISPOSAL•SY {IEM GRA tS REFER[:NCEO '10 FINISHzo FIRST FLOOR EEI- V A T lO?4 .UNLESS &HERWISE NL'TL'p. MPPROVIED SYSTEM' Fop w _ REVtslcNfi HOWA:fiD A. KELLY, Js' :. ASSOiIATES OFF oATf t3Y GARMEL 1JEW'YURK 1AN 2 4974 ( �o q'M Cl: t� tES/t61g < s U�ZOS� t n t'� ,, I 'TAX MAP NO. -72 BBLK.NO� i LOT NO.4 �N�d„ �1 ., "...; .- �,._�:,C--;Z ,�L`l;V •._ ,'� ll'!�.rT ,��} _ > c~ - TOWN- S)F i?A ula 51 Motenat -D18R ''DIVIf110N Of " -_ • ' ' . .,. Dfi1tIRUN(AENiRL HEALTH:!l�WO� il g y % �•••• . �( t^ Oh C -Uatc I 2- S.l+i Drowing PJa - r :, ct38, 4 rF OF Cw d��`� Tra.e4. •A09 �'