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HomeMy WebLinkAbout0687DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.11 -1-48 I ro III's No ,! s ■ rm !r iA I ,1 9 111 Is .� �. SEEL Is I s. LORETTA MOLINARI Public Health Director 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 Linda Root Pouder 143 Route 164 Patterson, NY 12563 Dear Ms. Root Pouder: ROBERT J. BONDI County $xecutive August 13, 2004 Re: Addition — Root Pouder, Rte. 164 No Increase in Number of Bedrooms (T) Patterson, TM #23.11 -1 -48 I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp from this Department dated August 12, 2004.The addition is approved with the following conditions. 1. The total number of bedrooms must remain at three without prior approval by this Department. 2.. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Patterson. If you have any questions, please contact me at your convenience. Sincerely, Michael Luke ML:lm Public Health Sanitarian cc: BI (T)Patterson D PAR MM 1 OF IMALTH D /vision of Environmental Health Serriees 4 Genava Road Brewster, New York: 10509 Tel. (9114) 278. 6130 Fax (914) 279 - 7911 D PROPOSED ADDYrIGNI ' PlI ATIOti BRUCE R. FOLZY Publi;: Hzclrh Dirk ;cr STREET M5 V T0W;ti" TX INIAP # LWPA-f DW- �£ 87$ 3z 0 NAME PHO:r'E PCHD r fL DESCRIPTION OF ADDITION NUMBER OF EMSTITING BEDROOMS (FROM CERT. 0: OCCUPANCY OR CERTIFICATION F?.3I l B LU D24G lti5°£CTOR) PROPOSED 4 OF BEDROGAS f0; 3 'Any addition vvhich is corn dared a bedroom requres formal approval of plans (Construction Peratif) prepared by a -rcfessional Engineer or Registered Arc! tect in accordance with aaplicabie sections cf tht Pusan Ca,=ty Sarituy Code. Please submit this form and the fo'lowing to P,&am Coun*y Health Dept., 4 Geneva Rd., Brcwster, 0509, Phone 278.6130. 1. Certified check or money order for 5100.00 Sketches or existing floor plari (drawn to scale,. all living area in basement) * von. - professional sketcl=s are acceptable 3. Two .sets o: proposed floor plan (drawn to scale, vtith name, street, and 'a:: rap T) * Non- profcssiona.i sketches are acceptable 4. Copy of slixyq Showing well and septic location, to the best of your k-,o�hled;e. Incl�.lde date of installation if kno,vn: Label all well's and septic systems within 200 feet of the property lire. Ccntact ibis office wi any questions, 5. Copy of Cent. of Occupancy frcm Town or Certification from Buildir:g Dept. `filth legal bedroom court of dwela -a. OFFICE U F Co:nrner,-s i:b 93 R DEPARTMENT OF HEALTH Division . Of Environmental Health Services Geneva' Road, Brewster, New York 10509 (914) 278 -6130 Putnt;r County Dept. of Health 4 Genova Road 37C1hSLC', Nip 10509 Residences BRUCE R._FOIE`1. F g Aetlna PUhila Mealth Ta P06fig %/ x ax M, 70 Tom ® . Gend'trnen: Accc2to re;,ords mai;►taired by.the Tu���t, the above noted dvvelling is IS 1, 1 i T .J i in corn-pliance v.;th T code and the total number of bedrooms cn record This infoir.°�ation ,has been obtailed from: CERTIFICATE, Or OCCUPANCY: ASSESSORS RECORD: O-L HER Building ins;,ector f a. PUTNAM- CQU.NTY . DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner -Pex)z>wiz .Address /41,5 Located at (Street) ' Tax Map - I I Block I_ Lot y� (indicate nearest cross street) Municipality , rr Watershed ,S ST ^ ��� SOIL PERCOLATION TEST DATA Date of Pre= soaking Date ,of Percolation Test NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top.of hole. Form DD -97 Shect .1 of PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEATLFI SERVICES FIELD ACTIVITY REPORT 10 ►d s [ .f A T)T)R F s s: %� 3 f I � T%�� '' iii A.i�, Street Town State Zip PERSON IN CHARGE nR TNTF.RVTFWFT) � 'eGt/J!� �ir��1I'� L/�.$lil ii/f natp, Name and Title TYPE OF FACILITY: !-Z-- f-�r iZ FINDINGS: TNO,PF.CTnR, TFT Signature and Title RFPnRT RFCFTVF.T) RY: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health December 24, 2007 Pennella Site Development 107 Dixon Road Carmel, NY 10512 Attn: Angelo Pennella Dear Mr. Pennella: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Septic System Contractor Licensing This correspondence serves as notification that Angelo Pennella has achieved a passing grade on the Putnam County Septic System Contractor Licensing Exam. However, a Septic System Contractor License can not be issued by this Department at this time due to the following box(es) which are checked: /The contractor's registration application on file with Putnam County Consumer Affairs does not list septic system installation and excavation as types of work performed by your business. t ❑ The liability insurance document on file with Putnam County Consumer Affairs does not rst excavation work under the description of operations. The liability insurance document on file with Putnam County Consumer Affairs does not list excavation and septic system installation work under the description of operations. ❑ The liability insurance document on file with Putnam County Consumer Affairs does not list septic system installation work under the description of operations. t ❑ The company (business) name on your septic system contractor licensing application on file with.this Department is not on file or has expired with Putnam County Consumer Affairs. 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 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES :ASAL FOR SEWAGE TREATMENT SYSTEM REPAIR YES NO internal Use Only PERMIT # 1-,- ffi -o)!�N n Repair Permit issued in last 5 years �❑ Not in Watershed n Repair within Boyd's Corners, W. Branch or Croton Falls Res. F Delegated El Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION I g22a1 (vy TOWNVATW6400 TM # 1-5'11 —t—C48 OWNER'S NAME N,IWG�ULA-e2� L- WPI PHONE # ifi6 MAILING ADDRESS �� 06 4(9L,?Q APPLICANT ©b,*%Q✓ jName & Relationship (i.e., owner, tenant, contractor) DATE `2, 0y FACILITY TYPE %�QS: S S i PCHD COMPLAINT # PROPOSED INSTALLER C2vyI Q_0 PHONE # l 4YS -Y7y • iV r ADDRESS 14,0—c\ 1 _e, L,t) REGISTRATION /LICENSE # &p YL Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair, LAJO/ ' rz- I, as owner,a a th ditions stated on t ih s form SIGNATU TITLE DATE (owner) I, the septic- installer, agree to comply with the conditions of this.permit for the septic system repair SIGNATORE - " _ TITLE,( DATEl C� Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. No completed work is to be backfilled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Pro al Approve Proposal Denied ❑ In ector's Signature & Title J419 �pC Date Expiration Date Repair proposal is in compliance with applicable codes Yes No D COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 143 rt 164 A to tank inlet cover A to tank outlet cover A to distribution box • to beginning of field 1 • to end of field 1 • to beginning of field 2 • to end of field 2 • to beginning of field 3 • to end of field 3 0 i 10 13� � {o i 3� b 30 �s 33 B to tank inlet cover B to tank outlet cover B to distribution box B to beginning of field 1 B to end of field 1 B to beginning of field 2 B to end of field 2 B to beginning of field 3 B to end of field 3 f t� s' f0 km 611 qp �OY� 'q11- � 71-5 * � rs CW Z'd 8L59-8L8 01101.001:pe8 40 1 nno 8o £Z A81N CEMCO Water & Wastewater Specialists LLC 59 Healey Lane - Stormville, New York 12582 Phone 845 878 -9711 - Fax 845 87U578 Roy Barticciotto NYS Certified Water & Wastewater Operator Sally Barticciotto NYS Certified Water Operator & Services Coordinator FACSIMILE TRANSMITTAL SHEET To: C From Company: �-- l� � Date: Fax # � % � — � G% � l Total pages (Inc. cover) Re: �� S, I ry-), CuL� T�'� �Y1P.�Sc.XZ.7J2P/r�5 UJ t -d 9L99-9L9 o}}oioollise Ao�j nano 90 9Z AeN PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner 'L 0 U 4� Address /1-13 fi-00k. 4 Y Located at (Street) OP N 3 /L.//'c (G i ( Tax Map _ (indicate nearest cross street) Municipality &JIC✓s .Watershed Date of Pre - soaking SOIL PERCOLATION TEST DATA Block Lot Date of Percolation Test X. De th to Water :.,... mater P From Ground Level Pereoattttu Tie EIS se Time :Surface (Inches) Dro In Rate Hole No Ruu No Start Stop �11'IEn) Start Stogy Inces Mrn/Inch ...... . 1 c2 3 9 lip 1 1 4 5 30 2 ,lak(ot 11,rh - Il,�t�i 3� lS- !S. � o, 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 May 16 08 12:5: 1p Roy Barticciotto 878 -6578 p.1 59 Healey Lane - Stormville, New York 12582 Phone 845 878 -9711 - Fax 845 878 -6578 Roy Bar#icciotto NYS Cert+fiied Water & Wastewater Operator Saliy Barticciotto NYS Certified Water Operator & Services Coordinator FACSIMILE TRANSMITTAL SHEET To:!% o� t Frorn:Q (' Company: ,- r' { Date: Fax r L7 9 -7 Total pages (Inc. cover) �7 Re: � (� c G lam'' 143 3 May 16 C8 12:51p Roy Bartiociotto o„ 878 -6578 S s E, /,-/'2 wcf (s w;A-�,'.,j zoO--�i Wei May 16 08 12:51 p Roy Barticciotto lei � Vt w /y7 878 -6578 p.3 APR-2-2008 12:30P FROM:KERNE COPPELMAN ENGI 19142416787 TO:18452787921 P.1 KEANE COPPELIVIAN ENGINEERS, P.C. CIVIL & ENVIRONMENTAL CONSULTANTS 113 SMITH AVENUE - MOUNT KISCO, NEW YORK 10549 (914) 241-2236 lnfo@keanecoppelman.com tax: (914) 241-6787 FACSIMILE TRANSMITTAL SHEET TO: FROM: jlmewh off o2 PER COMPANY: ILA YiQ>nl Cot in-&j I fh � - 1 1 FAX NUMBER: TOTAL NO. OF PAGES gqlg-- 2H- -+121 (INCLUDING COVER): PHONE NUMBER: RE: CC:: ReqUeA �r I n8oe0item - Iii 3 fte- I A. El URGENT ❑ FOR REVIEW 0 PLEASE COMMENT 0 PLEASE REPLY ❑ PLEASE RECYCLE NOTES/COMMENTS: I a A ('l tAitt(� - 1,1 -.1- ex. ( -g �t A IT-1 03 hoLl, VL) eq 1 7Z, s slope- n (2-- (jeleL �-d 411i""L jn'vl-- y Q: Z' -01A ci�m At Ik3 j�,4f Li Ar APR -2 -2078 12:30P FROM:KEANE COPPELMAN ENGI 19142416787 . T0:18452787921 P.2 . Y V V . V V I I Y V I 1 • Y I PUTNAM COUNTY HEALTH DaPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES THIS IS NOT A REPAIR PERMIT .. 1 OPOSAL FOR _EXPLORATION OF SEPTIC SYSTEM FAIL All information below must be L& y completed prior to any acheduling *South Side of Residence SITE I.CiCATiCEN 143 Route 164* TOWN Patterson TM # 2'3- 11 -1 -48 OWNER'S NAME Nick Pouder PHONE # 845 -878 -3323 MAILING ADDRESS 143 Rte, 1b40 vatteFson, NY 175rr-- An a oaPenella 225 -9212 PROPOSED CrpNTRACTdRlWSTALLER 8 PHONE # ADDRESS 107 Dixon Road, Carmel REGISTRATION /LICENSE 4 1094- Beason for aggloM1213,R o failure to surface 0 back -up In house 0 find limits of system for repairJU other (explain below) FOR GOUNly U §E,- ONIL.Y Inspector's Signatur® & Title Date /& (Appointment Date. Time; Wy ; excel: septic MAR-19 -2008 03:44P FROM:KEANE COPPELMAN ENGI- 19142416787 TO:184527e7921 P.2 1 "M r.UUI /UuI F -ZUI PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES THIS IS NOT A REPAIR PERMIT PROP12SAL FOR EXPLORATION OF SEPTIC SYSTEM F (LURE All information below must beL completed prior to any scheduling *South Side of Residence SITE LOCATION 143 Route .164* TOWN Patterson TM # 23- 11 -1 -48 OWNER'S NAME Nick Pouder PHONE # 845- 878 -3323 MAILING ADDRESS 143 Rte. lb4, Fatterson, na oaPene A PROPOSED CONTRACTOR/INSTALLER S lla PHONE # 225 -9212 ADDRESS 107 Dixon Road, Carmel REGISTRATION /LICENSE to. x.095----r Resort for excloratiom 0 failure to surface Q back -up In house ❑ find Urn is of system for repalr3gother (explaln below) FOR COUNTY Ujj-0N6X Inspector's Signature & Title Date .01W Appointment Date: Time: [c1y;exc41:septic MAR -19 -2008 03:44P FROM:KEANE COPPELMAN ENGI 19142416787 TO:18452787921 P.1 KEANE COPPELMAN ENGINEERS, P.C. CIVIL & ENVIRONMENTAL CONSULTANTS 113 SMITH AVENUE - MOUNT KISCO, NEW YORK 10549 (914) 241 -2235 info@keanecoppelman.com fax: (914) 241 -6787 FACSIMILE TRANSMITTAL SHEET TO: FROM: m•'w COMPANY: DATE: FAX NUMBER: I v TOTAL N0. -OF PAGES alls) c2TR_ A917 I (INCLUDING COVER): a PHONE NUMBER: RE: CC:: Pouder- IY3 Koute 164 E7. ❑ URGENT ❑ FOR REVIEW ❑ PLEASE COMMENT ❑ PLEASE REPLY ❑ PLEASE RECYCLE NOTES /COMMENTS: c'J4nP a ' � � _ • .GI owj/. rte' dr, n. 1i FEB -19 -2008 11:56A FROM:KEANE COPPELMAN ENGI 19142416787 TO:18452787921 P.2 n rr .... . . siwm rnr i-w- -i in6 nan.m 090L101 OLI I"J00 r•uu l /uui r"[ul PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES THIS IS NOT A REPAIR PERMIT PRGiPOSAL FQR EXpLO - TIC3N OF SEPTIC SYSTEM FAILURE All information below must be fg1l y completed prior to any scheduling *South Side of Residence SITE LOCATION 143 Route 164* TOWN Patterson TM # 2J- 11 -1 -48 OWNER'S NAME Nick Pouder PHONE # 845 --878 -3323 MAILING ADDRESS 14 Rtd. 740 Patterson, PROPOSED CONTRACTOR /INSTALLER Ange oaPend la PHQIVE # 225 -9212 ADDRESS 107 Dixon Road, Carmel REGISTRATION /LICENSE # • IQ Reason for exniarallen, ❑ fallure to surface Q track -up In house O find Ilmho of system for repalrHother (explaln below) FQ8_G,QUM USE ONLY nspector's Signature & Title Date Date: r ; /a;e;pTime; kly:excal:septic FEB -19 -2008 11:56A FROM:KEANE COPPELMAN ENGI 19142416787 TO:18452787921 P.1 0 lEANE COPPELMAN ENGINEERS, P.C. CIVIL & ENVIRONMENTAL CONSULTANTS 113 SMITH AVENUE - MOUNT KISCO, NEW YORK 10549 (914) 241 -2235 info *keanecoppelman.com fax: (914) 241 -6787 FACSIMILE TRANSMITTAL SHEET TO: FROM: . COMPANY: DATE: FAX NUMBER: ' TOTAL NO. OF PAGES �►��- a�g_� (INCLUDING COVER): PHONE NUMBER: RE: CO: P., "A'., _ ,,1 Iz 0._L., t► v 0 URGENT ❑ FOR REVIEW D PLEASE COMMENT O PLEASE REPLY 0 PLEASE RECYCLE NOTES /COMMENTS: 4 ©q P/0 23.07-1-6 8 6403 M 966000 IJ I _ r 6400 3a F--& / 39 / 06 5000 e / 6490 61. 6 JI z2J.s36r / JF 3 !r 9400 $928 �0 Ar s�00 57 .65 � rr 11 / 6000 6439 JI / � 7Na^ � -!-U ` J/ r 8 x J/ l 1 IB 1321 Pd 19; SJ Jo J ` Ps ,� \ --4. Jo l IP /PPV \ 1� 59 T Pl $ l \ e I p/ it 4109 AC.1 / / 1 I� \ t" \ w° 1 / 1.08 AC. CAL. All 6P II � / PI /PJ� � 1 ~'g PX � ♦�� ti 60 J 45 62 s � , l p�0g W 94.29 , / \ I/ `� /3y/l8400 h �\Q 124.00 1.15 AC./ / 1+409 I 61, J� / J/ / l \ \ pJ / / i,J 4i� `�tP •'v J9 / 6,10j 2,�,j7� ` 0O PP 63 /6 / / J\ 10 5 0° 1. 31, AC. / \�' / :9 LTBAC. 64 S 121.0 65 /d ? 54 JO 1.25AC. e / rP 104.09 \ 18 / \ /s / 8 6s' \ e f s� / /LOS AC. 1.41\ AC. CAL. / 12 _ — — — — — 8 \ s Y why; 3,101 �0! II by 21 4 $ \69.10 P9 0 /! 171.90 66 IJ 58.10 S a 13�� r 's \ Ile 16 g ° �' /J g 100.00 BZ2s is / e IP 23 g' S \h229 ° /o / Pe ► ?\ i /17 6 $ 9 67 y 68 114 J9 / 13�OI b S 64.64 / 12d // a6 // B\ 9�J � � � � ,Jv � `b 96& 5 \�0 39 J3 0 $ ROAD >y 261.11 jr / : 15 ,0 \ e $/J /.y� „I� SS.0 s3 yP 6 0 1p��0 Ji •� /t 16480 p / 5; / / 10 / // / 4 / I I / /0 / I 45, 9 / 6017 0. l . I l 6010 / 7 one, 6433 / 6' JAN -23 -2008 12:36P FROM:KEANE COPPELMAN ENGI 19142416787 TO:18452787921 P.2 JAN-22 -2008 03 :12PM FROM- ENViRONNIENTAL HEALTH 8452787921 T -338 P.001/001 F-201 . PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES THIS IS NOT A REPAIR PERMIT PRO OSAL FOR EXPLORATION OF SEPTIC SYSTEM FAILURE All information below must be # tjy completed prior to any scheduling *South Side of Residence SITE LOCATION 143 Rout X164* _ TOWN Patterson TM # 23- 11 -1 -48 OWNER'S NAME Nick Pouder PHONE # 845- 878 -3323 MAILING ADDRESS te. 1b4j Patterson, PROPOSED CONTRACTORIINSTALLER AngeloaPeneila PHONE # 225 -9212 ADDRESS 107 Dixon Road, Carmel REGISTRATION /LICENSE # Pending - has not received- ece .ve t in the mail Ranson for exnloratia: yet. 0 failure to surtace LD back up in house O find limits of system for repalr3a other (explain below) Seeving irxto basement on occasion. O. i 111 L.0 nspectar's Signature & Title Date .#, Appointment Date: Time: kly.excei:septic �c 0 I. PIN FNr.' � I P /06 00 JQu/ I N/F MOUNT 0 42866 \ \0P SLOPE 0,984 AC-4 UI I lu 0 /\Ind \ Q 1. PIN FNO CGI / I GORNER :�•� LL I P.DRIVE I ~� I. 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