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631- 589 -8100
23.11 -1 -4
BOX 8
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00672
BRUCE R. FOLEY
Public Health Director
Robert Morrera
Mt. View Rd.
Patterson, NY 12563
Dear Mr. Morrera:
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 (914) 278 - 6130 Fax (914) 278 = 7921
Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085
Early Intervention (914) 278 - 6014 Fax (914) 278 - 6Apr119, 1999
WIC (914) 278 - 6678 Fax (914) 278 - 6085
Re: Addition- Morrera- Mt. View Rd.
No Increases in Number of Bedrooms
(T) Patterson Tax # 23.11 -1 -4
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 form this Department dated April 9: 1999 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.
1 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 yours,
Michael Luke
MI,:kg Public Health Technician
Cc:BI
I
-t.
0
DEPARTMENT OF HEALTH
Division of Environmental Health .Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLYI
BRUCE R. FOLEY
Public Health Director
6t 72
STREETI'.I`.�;� . (!✓.[�.c: ,�� TOWN X MAP #
NAME PHONE 2 HD # g�
D
MAILING ADDRESS J� `� o win -�c� \/ t:�.J (Zd, , 1 a�, ei✓�a,n tJ� 1 Z:sb�
DESCRIPTION OF ADDITION,,/,���z1���JVr.�'
NUMBER OF EXISTING BEDROOMS 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 Rd.,
Brewster, NY 10509, Phone 278 -6130.
r 1. Certified check or money order for $100.00
/2. Sketches of existing floor plan (drawn to scale, all living area including basement)
* Non - professional sketches are acceptable
v 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.
d 5. Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
OFFICE USE
Comments
Feb 98
". :
DEPARTMENT OF HEALTH
Division . Of Environmental Health, services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Gentlemen:
BRUCE R. FOLEY, R.S.
Acting Public .Health Director
• _ � l c1 �i.�f �
Tax Ma
To=
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 -.3
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER
L'o. dz�' . .
$uilding Inspector
fix"':: �ti.""°":.%:? � +�'.. -'F"S::",�'xt�", ..,..R: st.:�." e'�SNZa."xi- " >t�+.i��w:..r� �i�.Zfg?,i'�'c'Y"�' ' a'�c'�';.{I'r" ;t._ �._,. _ .:.�'.`� y.•..:�;.
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LOCAMN: W-TERSON, MY
OAM 7-12-:-,3-
COMMUOR:
261
rFLV.i _FOU_ndavon _P1_cn FOY
UR A'''F'RCYA! : r0 5NUP: TU � .tLPr.
F � R APP1tUb'AL AS (3iiP_:
FAV1, t3Y: FI 17... �<.
1
IT-P
2x4 collar ties 32
inches an center to
2x6 rafters 16" an 51-311
center Marvin CDH2O14 Double Marvin
CDMO14
Aluminum ucy
flashin 71(ty vapical)
I new iaoF
. . . . . . . . . . . . . . .
Ex M Bedroom!"
Attic
Coll" Ties 5'4� on center (match cjdsfing)7
Upper Livi
L
3I432 SK -3
1Mafeh Dew with existing alt
20'
A
;�� L�J
per
trunudacturar's $ trip new roofing inII
tinJJ
recommandati
6-61'
A
See clovatio 9
Y-L
for false
Relocated Q --dorracrabove-
pull-down
stairway = Attic
.�C
...... .... .
3 BEDROOMS
Mr
�_,;Wmra a �
>
Dii.
New walls am 2x4
Wd2
with 4° insulation
and 5/8"FRSR
each side
See clovatio 9
Y-L
for false
Relocated Q --dorracrabove-
pull-down
stairway = Attic
.�C
...... .... .
.. ... .....
>
Storage
Wd2
Loft
Double Closer
-Sister new 2x6
rafters to existing
...........
to atW with new
rafters .........................
....
Ex Bedim
Ex Bedrm
New Dcd=p
New double 2x i Bed nook
header and jack
studa to hazing
below
T_
Doubts Marvin
Double Marvin
3"
I
CDH3014
CDMO14
arch down roof 18"Microtam
beam flush at
guage ceiling 121
29'-10"
AFr in attic storage
loft clad in FRSR
Tbc windows are shown with
Mania catalog nanobars to fit
existing openings or new
S. attached Door Schedule far
am and quantity of units
M a e A*, 23. t I - I -
Morrem Rpmeidpnc
Dili
I
MR!
Fuciatin8 house
strU Wte era
remain to be
reflnishcd as
regnirod
wherever shown
thus) .
Under screened h --
CW2430
Railing continuous @ 3 -41 AFF:
30-3 4x4 posts 48° on cotdrA
Open Dec— Screened in Porch
2x6 rafters 16"m center
6' - la' -0 ,• martin
830 036 CFDR6068
P OX 1:.110 So-3
- --
2F-C
7- step
-- —
labs
r
W3630 Align wall with old Ileoal
4DIi36 ! I
No ees un bn n�ertd to I
' SoLchBasna Sbrage
21 36 ! door !fame Closet
L 2
Block
Block
Coordinaln removal
Dw 1 B Filler after new - • ' "-
®I to functional
Black
6
W
s S1136 Ki lilt u' -t• PmayCloset a•_e. -
tchen Breakfast Nook
1 612 M 4
—'— —frig Bide panels 7t ,� ty.„
31 -3 Mud 1\111 `I'Do
2 2' - `5 � -
36 WM 361
SheNce SI -23 �
('
30
\-W I230
Ewting 3 ' pi. finish is W be
2boaed
Bbck /PT
Up
-- tl• -2�• 4'- io• ---� 4' rm.. 'nod and a�tendcd into new areas from
Black
°O$$
I the materiel salvaged $om ceiling and other
U4' weber prodmosotib oe�te wh poy
pf
d
eeaa
demo er - - - -1
\
dds
.
Dining Roo Living Room
5'_6'
UWRoom
Cortade
w
Suter existing stu a to align with
_
Block
F' new addition 2x6 alon and
2' i fill with new A -19 inaWation 7w. _ p•
Dili
I
MR!
Fuciatin8 house
strU Wte era
remain to be
reflnishcd as
regnirod
wherever shown
thus) .
Under screened h --
Po
parge
pup
Was
labs
eaeen
No ees un bn n�ertd to I
' SoLchBasna Sbrage
Cow
Block
Block
Bock
Black
WPM
114•rebrpmef=csngwnp*
vqwba.b. aide' h
Crew Speoe
2boaed
Bbck /PT
Black
Black
Block
W.PM
U4' weber prodmosotib oe�te wh poy
dds
Vapor barrier and it berWass h Joist
UWRoom
Cortade
WRSR
WRSR
Block
Black
FRSR
SW torebddleatockcetigwhS'
mesodb
Wotan bar
BasemeN Bdwoan
Tie 8
WRSR
WRSR
WRSR
WRSR
WRSR
Ce6g dtpas am W.C.. hWW tor
awe
Foyer
Tb 8
WRSR
WRSR
WRSR
WRSR
WRSR
bm83s tor W e° FFF
cave
on trft
an
Ex gSbmp
Can
WRSR
WRSR
WRSR
WRSR
I WRSR
St#rmigltwh2c4bxpnwhrew
on
on
an
on2c4
stcwft dernedrrckdworl
Gave
a
a
ded9
I a
a
818FROB
CWWbbe5Wkerst 1-1, span
(FRSR)
Fled Fbor Lovel
Open Deck rd VM wsy PT 2t4 atsldhp ed ddkg Ra6g Rebg to dy Presrae Feebd sotAern yebw pke bat
a emistj molstntwftd mebrbl
SaawadhPorch
Pr as
Plskxs/
T -111
Prsixis/
PTAx l
WJW
dwabrdoe6gbbewaWfomboad
screen
rwaan
screen
Yduslon and over heafto
KMen
Pergte
hibe
Has
Was
Pdbd
IAhooghashwh deal ddd�plrat
31
S.R.
bba eseKbfendebb
BrsadtWNook
Pergte
Palled
Palled
-
Shedodc
Pai
Vtbodbeatvotgtot/
Oak
SR.
SR.
S.R.
Mud Room
NCT d
Palled
Pdbd
Pekbd
Pakft
Pak tbd
Fbor drain b aewl speco rsr rester
boo
I S.R.
S.R.
S.R.
SR.
SR.
Dft Room
meth
PeHbd
Pat
Pak led
T&Opbe
Pd bd
CatrbebmeChabtrg.Kn*pkeon
314°od
S.R.
S.R.
S.R.
S.R.
Wad wdbbengcbd tam drm.Fhsh
,plaboaktalngtonalchnift
UAW Roan
Pebh 314•
Path
Pak ied
Pehled
Patlt T&O
Pd bd
Skier East wd Axe b abaswh rim 20
oA
Tdf3
SR.
SR.
pke
SR.
wet add 8°kmAdcn.ReHdt kwft
Edema
Ftgsbns
Pdlsd
Pak
Pak bd
POW
Pd
Areabdwaenslbsadgbyrkworkby
-
SR.
SR.
SR,
SR
S.R.
owner
Frord Porch
Fbpsbro
-
PT ral%
T -111
T -111
T -111
111 bbe daked and 88014 war
ITMn
yvsk an abtbg deetig a row
SemM Fba
A
Aft Aaepa over perape
06
mbre
Arffi
fir
okxb
98'
beck ddb of be is rebel deetod
FRSR
FRSR
VYArC
WSR
1/2'SR
11TSR
12°SR
112!'SR
ShWasrdpobsea6ham
�Cbwb
PVwood
I
" 79 1. TWX,w ! Front Porch ��
OP Dn' New Ccmemte slab an gmde eiaped
— 16' -10' 6 ' — 6' 4° m firont for dmiaagc, 4x4 wwm, 4" 4° s�
Entrance St-1 eta,, an 4 mil poly V33. ®4" pawl
We -wood railing between 4x4 posh
t�� 4w r -r F-- —c — �-- -e —I PUTNAM COUNTY DEPARTMENT OF HEALTH
HOUSE PLANS APPROVED FOR
A BEDROOM COUNT ONLY;
BEDROOMS
Stgnatu Date
TRx. MAf-W
c� 4-r, � n +� �r � � ttn � L1 � •r•� � L� � .+ ...« T ..� „..1 l D_ � �.. ... � L \ �® Monera Residence
mucl
2.8 PT J.b� existing ftioting;
=0 then backfill to Smile the entire wall
7
2x6 P" Joist water
16" on center Cut 2 now
openings; in
8, treatment utility
Storage
block wall 41 pworm
lCqqCiBt 16-
L OFT)
bridging retaining Won
- Slope existing Ncw 9 1/2" deep Mitch plate Girder. T000
with concrctc
shelftoalign dirt floor as existing 2xg joist and sister with W�e to be
131-2.6 flugh with gWa Litrotighout basement ceiling
T-41 with new screed - shown and cam
3-2xl 2 Order at mid span
L. 4mill Poly then New 4- disaider Lary colarnin with shoes to
Prufab Sump pit receive existing and new flitch girders set in
1) in new oancmu: new 24x24xg Inch fboft flash with floor
flow Bath
New
ottercto
T-41 club w/ 4x4 G. Crawl Space Existing Garage
4' rotten at, 'd wan Bi-4 2x6 Joist
with PT 2x4 and 1611 an cmter
sidd am is door Bring existing
--mm W:22m New Smage do= by Owner's
Foyer 8"blockwall subcontractor. Coardinate, all
nsc
openings with maindlichinar
it-2.5 A, SIA to sill elevad
Bilco cap over stairs Concrete steps 32"xl6' Caller window (2) clad windmn fim owner to be installed
to hmch drain
for accass as we
required 6'-6' G'-6' receive new microlam girder and
coordirtz" WWI
um�/" — punvxMnounr/ DEPARTMENT oFHEALTH �
/ ^ / HOUSE PLANS APPROVED FOR
BEDROOM COUNT ONLY;
( BEDROONIS
|
°g"u."" Title ~ ~.~
4 PT —�
-king 4"
C. (or equal)
8 PT Joist —
" O.C. with
tcap under
;king
Klatch existing
facia with
return for
future vinyl
soffit
Tyvck on 1/2"
CDX plywood
sheathing on
2x6 studs 16"
O.C. with 6"
fiberglass —,/
4 bars set into
" hole with '
on- shrink
o 2" expanded
ro ut (2 every `' • •: .`
tt poly styrene
.I
O:
Alternate
footing pinned
to bedrock if
required
25# shingle
similar to
existing on 15#
felt on 1/2"
CDX plyscord
on 2x8 rafters
16" on center
9" fiberglass
between 2x6
ceiling joist --
16" on center
ridge vent
above
Double 2x6
collar ties 64"
on center tie
across to rear
wall
Strip new floor
into existing — Existing
House
2" concrete on
2 layers 4 mil
poly =�
New 8" block
and footing as
req'd to reach
depth
Section thru Knee Wall
Double headers
arounf
openings
(typical)
Prefab
42 Unit
Flush slate
hearth on
concrete —1
r
2" poly styrene
on 3/4" CDX
IMI
25# shingle
similar to
existing on 15#
felt on 1/2"
CDX plyscord
on 2x12 rafters
16" on center
9" insulation
with 2 1/2" air
space (Typ.)
Match soffit
for Vinyl
Shelf unit to be
built both sides
of a wall in this
area
$" Block with
durowall every
;
other course
1/8" Me
exterior side
w/ foundation
'
tar to grade
1
4" perferated
pipe footing
b ' drain wrapped
in gravel &
filter fabric
TRx rnAf -4 23,11 -1-
(Irn e c 4Z Ar%+; r%" A tTU,. ,. Morrem Residence
Match existing mnf.qlnrm and
windows with torch down New-
roolling stripped into new roof WM.---' - 1, 2x4 false rafter with 1/2" VC
unit and flashed to existing wan unit plywood ociHng dMI-out
exterior parch
W rafters 1611 on center with
typical shingle roof system
without insulation
2 -2x10 girder
2 risers Sister, joist Fill in block with 1/21'
W' n
t
Window
false
nZ,
Sister � with 4
7-1/2" with 2x4 wall to match plywood
continuous Bill between 4x4
2-4 to Posts
-Taper 7-
concrete on existing,
existing stab
. F-P
Section "C" and Further Sections Through Front Porch
Ridge vent and W ridge
board below
2x6 rafters 16" O.C. with
2x4 collar ties 48" O.C.
exposed to interior
Vinyl comer boards
2x6 mitered top rail with
2x4 backer; 2x4 toe brace
and prefab vertical alas all
pressure treated lumber
Section "B" Through Screened in Porch and Deck
C7-
io— U" N I D=wn BY Scale: Date: Revision W-1— I DIM-M. W.-bw
i
i
Bedroom
1
Existing
Strip into F, S$g
existing roof 12"
and re -flash
chimney 2x4 wall w/ 5/8"
F.R.S.R. both - - --
__._.._ sides and 4"
insulation 4x4 posts clad .
_ with w/ 5/8" 2x8 rafters 16"
F.R.S.R.48" on O.C. with
BedrillS CI Set `tom - standard roof
StTTora/�Tj��,ge detail, 5/8"
FRSR interior ,—
New 2x4 end
wall both ends
B
-i - - -- - -• - - --
18 "deep
2x6 floor joist — laminated beam .
Existing 16" on center w/ flush at bottom
stg 1 /2" CDX floor
with joist clad
{ & 5/8" FRSR with 5/8 "FRSR
ceiling below Existing Garage
I �
Section near Nest ]Edge
standard roof
detail
Exaust Fan
2x4 studs 16"
O.C. 1/2" CDX
and tyvek cover
32x48 opening
Storage
New PT 2x8 sill
Oft
anchored into
existing block
Soffit to match
existing
P
2
18 "deep
2x6 floor joist
laminated beam
16" on center w/
flush at bottom
r
1/2 CDX floor
With joist clad
I & 5/8" FRSR
with 5/8 "FRSR
ceiling below
EX1Sting Garage
Section thru Dormer and Bedroom ITT® ®k
New PT 2x8 sill
anchored into
existing block
Soffit to match
existing
'T'Rx maP -A 23.1I -I -y
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INITIAL INDIVUDAL ADDITION/REPAIR FORM
SECTION A: GENERAL INFORMATION
Name of Project ->-V _(T)( TM#
Year of Construction Size of Parcel
SECTION $. TOPOGRAPHY (Please check all"appropriate boxes)
1. Of 6y ❑Rolling ( teep Slope Gentle Slope ❑Flat
2. LjEvidence of wetland ❑Low area subject to flooding ❑Bodies of water
ODrainage ditches ❑Rock outcrop
.. �'.
YES 3. Property lines evident? ❑ -1�
4. Water courses exist on, or adjacent to parcel: U s'
5. Existing individual wells within 200 ft of the existing SSTS? lL O
SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) .
1. Physical character of existing SSTS area.
A. ` ❑Level 1 Gentle Slope ❑Steep slope
B. ❑Well drained ❑Moderately well drained
msom,ewhat poorly drained OPoorly drained
C. Area available for SSTS. (Primary, & Reserve)
❑Extremely limited Somewhat limited ❑Adequate ft x ft
D. INSPECTION Date Inspector
No evidence of failure (Evidence of failure vidence of seasonal failure.
---------- =°--= -------------------------------------------------- ---------------=------- - - - - -.
(Indicate North)
h
E Housr
A
---------------------------- --.! ------------- ------------------------- ----------- --
I
(1) Indicate location of SSTS
A. Size and type of septic tank gallons
M'Metal floncrete OPlastid
B. Type of absorption area .
1. Fields ft. 1 Pits 3. Gallies ft.
(2) Indicate setbacks, front street, backyard, and side yard dimensions
(3) Show location of well
(4) Show location of driveway
(5) Note physical features (steep slopes, rock outcrops, streams /wetlands)
SECTION E. EXISTING WATER SUPPLY
[]PWS ❑Shared well
Individual well
Dulled 0Dug M<Casing above ground
COM&ENTS :
REPAIRS ONLY: Status:
As Built Inspection Required: As Built Submitted:
As Built Inspection Done: Inspector:
Owner or Purchaser o Building
F rr ' fiW 131e 1 +
Bui ding Constructe y
Mott N�Vlow Rdodl
Location - Street
Frame
Building Type
t
Muni cipa ity
Section
C
Block
Lot
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 the standards, rules and regulations of the Putnam
County Department of Health; and hereby guaranty to the owner, his succes-
sors, 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 de-
termination of the Director of the Division of Environmental Health Ser-
vices of the Putnam County Department of Health as to wheth6r or not the
failure of the system..to operate was caused by'the will ul or negligent
act of the occupant of the building utilizing the syst /.�
Dated this day of { ♦ 1971 Signature
Title �
ii' corporation, give name
and 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
n:
1
WELL COMPLETION REPORT PUTNAM COUNTY DEPARTMENT OF HEALTH
3/71 Division of Environmental Health Services
COUNTY OFFICE BUILDING - CARMEL, NEW YORK
7 �-
This report is to be completed by well driller and subrpitted 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
_
ADDRESS
LOCATION
OF WELL
(No. & Street) (Town) (Lot Number)
AwNbAdY ph,110,goly 0
PROPOSED
USE OF
WELL WELL
'
tDOMESTIC ., � BUSINESS ❑
E] ESTABLISHMENT ❑FARM TEST WELL '
6'-
❑ SUPPLY ❑ INDUSTRIAL ❑ AIR ❑ OTHER
CONDITIONING (Specify)
DRILLING
EQUIPMENT
OMPRESSED CABLE OTHER
11 ROTARY AIR PERCUSSION ❑PERCUSSION 1:1 (Specify)
CASING
DETAILS
LENGTH (feet)
DIAMETER (inches)
/ !r
WEIGHT PER FOOT
?J
E" THREADED ❑ WELDED
DR1.S O
L_J YES ❑ NO
G
YES
�j D?
LJ NO
YIELD
TEST
HOURS G.P.M.
❑ BAILED ❑ PUMPED ZCOMPRESSED AIR
YIELD.(G.P.M.)
WATER
LEVEL
MEASURE FROM LAND SURFACE —STATIC (Speclfy feet)
IS-
DURING YIELD TEST feet) l
TStAl a4v ,v
Depth of Completed Well
/
in feet below land surface:
SCREEN
DETAILS
MAKE
LENGTH OPEN TO AQUIFER (fset)
SLOT SIZE .
DIAMETER (Inches)
IF GRAVEL
PACKED:
Diameter of well including
gravel pack (Inches):
GRAVEL SIZE (Inches) FROM (feet) TO (feet)
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION
Sketch exact location of well with distances, to at least
two permanent landmarks.
FEET. to FEET
cl
Q�
P4
BOYD, ARTESIAN JELL 0
RFD 3
If yield was tested at different depths during drilling, list below
FEET
GALLONS PER MINUTE
DATE ELL COMPLETED
ALL21
DATE OF R PORT
,
IWELLDFRILLER (Sig ature) ROUTE 52
CARI1IEL, N.Y.
/7 /
3,
Jan. c
BREWSTER , LABORATORIES
Box 224 - BREWSTER, N. Y.
WATER. ANALYSIS REPORT
SAMPLE NO. 2649
SOURCE: Forrester Builders, Inc. - faucet
Lot . 7 -8 -9
Mountain View Road
Patterson, N. Y.
COLLECTED: Jan. 7, 1972
BY: 6Yi Z l iam .Bush
BACTERIOLOGICAL EXAMINATION
Coliform Count, MF Method
This result
indicates the
source of
the sample was
of satisfactory sanitary
quality when
the sample
was collected.
0 per 100 ml.
a' written -g
of
the-diri0iiiate-oi -Construction 'Compliance:
be'loc6ted as sih-biwn,on the'IIPp4ioid.-_plan and t hai 41:"Said wall �&i),
`County Department of Health
aDate '',
0 S ig ri p, d"_
/7,
Address
;APPROVED FOR CONSTRUCTION ?tThis approva li expires one
revocable for c
i ' i ' " eons
id
or may be amended or� r�6d ifie6 vvhen.eonsld
i i "i'domestic
"
requires a new �perrnit..' Appr 0
Date By
roof a',',Gartif
Will, be Nth!
to -of '.C6n'itruciion"iC6-ehpiiand6i-'saii"Siac't:or . y to . th6C' m
OmISiiO;ner of HealthWill
id by the builder, I the t - "sa id builder , . 'will
M duri!ig:.trie '.pe.riod'o-i.t.,w.,.o,(2l') years lmmediatelY,!, 69wing the date of'the`lSSu-,,j
,igihaj, system i :o-'2):thii pd lied Well ide . scribed above
hiori any �repa rs- hereto e r,
ed iA. accordance with 'the 'jIta)jdoiii6i," rules and r660571`onsof ''the Putnam*
P.E.1— R.A.
L I cerise No;/
he date ;.Issued; unibcsPonstruction of the b6'iidin6'-has een'undertaken�::iiiod: is '•
ry e-4y 'thre!,;,**6ner of,'Health. Any change or ,alteration of construction` to Water supply only.,
Title
0U7NAM c6uNTY
" PA'tTERQON NtW' YORK
OFFICE OF _ ° 1 L 1 I • ' (
r .
06NALD W SWT �
SUPERVISOR .
li661" L;
kc vi1liam. Bash.
' �1dlm d '/en7'G & �L#� i 7 }{.b•'S y ` tY4
Patterson, York 12563
The Highwa Department of the Town of Patterson
1:ara ts` pern ss 6h. to Forrester Bui lders, Inc. t-o
insUl'1 -inch gorra6ated Metal -'pipe across Nit.
View Roach, too. carry water f lot 6 section ,C to
rese rued. area betiuee i `lot `7- ,and S section D,
Work must he cane °uZi iF?r sup e 3 Sidi] Of the
' Highway Supers. ltenden.t .±
- Respectfully .yours,
David Snraq.ue
Nn3y SiipeAr
L . D: jar
3 Ad If A&LI
4
5
3 /oi4L
®a
Notes.
1) Pests to� be. repeated at' ,same depth until approx1r is I- v equal soil rates are ob-
tained at' ':each •percola.tion test hole. 'All data :o be submitted for review.
2.) Depth measurements to be -made from top of hole_.
PUTNAM
COUNTY DEPARTMENT'OF HEALTH
DhVISION OF
ENVIRONNME' , HEr LTH SERVICES
DESIGN.-DATA SHEET . - SEPARATE
SE.�TAGE. DISPOSAL SYSTEM FILE NO.
Owne
Addressd..rd►�H�i�Orel eQ,
Located at . (Street).:
ec . lock .: ,,
Lot h
(:Indicate nearest cross street) ;
Munici' alit �►gj Watershed �e
P Y. 4'r.►
F�'=J ilin tr� S h
._SOIL PERCOLATION TEST .DATA'
REOUIRED 70 BE SUBMITTED WITH APPLIC!ATI;ON
Hole '
" Number CLOCK TIME .
PERCOL_4TIOT:. .
PERCOLATION
Run:.: Elapse
Depth to :;rater.:. Water.. Level Y .:`•
No . :. Time
From Ground Sur: ac e in ':Inches .. , =
Soil' ` .-Rate
Start Stop Min.
Start Stop Drop .in ..
Min/in. drop
Inches Inches Inches.
2 /O *J tip 19
3 Ad If A&LI
4
5
3 /oi4L
®a
Notes.
1) Pests to� be. repeated at' ,same depth until approx1r is I- v equal soil rates are ob-
tained at' ':each •percola.tion test hole. 'All data :o be submitted for review.
2.) Depth measurements to be -made from top of hole_.
PUTNAM COUNTY .DEPART�MNT. OF HEALTH L AQ
Soil Rate Approved Sq. Ft: /Gal . Checked b�: F���� ��' 2g2�6 F�'�`� Date
i.
'T
v -Pil41
if
Ew,
W 7'
i A i�� ifJh,
F"N
xk
IV
AIR
-ram
-Lry
r)
'6w,
ep,
r7
171 C,
FA