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HomeMy WebLinkAbout0689DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 23.11 -1 -67 Mai T Im t�N .. , y ,-.—,r T. r. BRUCE R. FOLEY Acting Public Health Director DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fax (914) 278 - 7921 June 23, 1997 Enrico & Megan Caprari 266 Mountain View Road Patterson, NY 12563 Re: Addition - Caprari 266 Mt. View Road No increase in number of bedrooms (T) Patterson TM #23.11 -1 -67 Dear 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 June 20, 1997 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 four 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. `H/jp Very truly yours, William Hedges Sr. Public Health Sanitarian I . y d; BRUCE R.' FOLEY, R.S Acting Public Health Dire:;c,, DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva . Road, Brewster, New York 10509 (914) 278-6130 PROPOSED ADDITION APPLICATION _ (RESIDENTIAL ONLY "�V/ L STREET: Ad • U L et:.,) TO4,N PC l( Q_60 tA_ TX MAP $ "� -� 3•z 6I7 8,�% NA14E:r- %ca PHONE' PCHD PERMIT # 97 MAILING ADDRESS }; Q_ 2� _v',o,c 2_6b PC, �kiSCIA r• Description of.Addition SukA pocq\ QW C61, n \!b4s� (Z1ClVL Number of existing bedrooms Proposed number of bedrooms __9_ from Certificate 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 PUTU M COUIfiY HEALTH DEPARTMENT, 4 GENEVA ROAD, BREWSTER, NY 10509, Phone 278 -6130 with the following information. 1. Certified Check for $100.00. 2. Sketch of existing floor plan (all living area including basement, if any) Non - professional drawing is acceptable. 3. Sketch of proposed floor plan. Non professional drawing is acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Include all wells and septic systems within 200 feet of property line. Any questions please contact this office. 5. Copy of Certificate of Occupancy from Town or Certification from Building Department of legal bedroom count of dwelling. OFFICE USE Comments and /or conditions application August 1995 July 1996 (Revised) 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. p,s. Acting Public Health Director Re: ° _A � Residince Tax Maps, ' . --1-07 To"M Z� According to records maintained by the To"m, the above noted dwelling IS IS NOT in compliance with ToNti.-n code and is This information has been obtaine( CERTIFICATE OF OCCUPANCY ASSESSORS RECORD: OTHER N If. ,N. C.1ba .. � HULLDWG Pi6PECTOR �.. -'-y 20N°V6 ADMT�BTRATOR COD@ V , CMC KMFNT 0P7nCER / I TOWN OP PATTPJtBON C\ R .160 a9n PATTER60N, N.Y. 1II 69 rk Y C_ :: _ 1 qi C_ ry ti yr � f3�-ti,Z on, AS BUILT" DATA. 2U(o M�K�1i �Rz� T� � -st Structure located from survey by .surveyor noted below V- 7 _i . Well located by: Surveyors survey•_ - �_ _ v =7µ _ -- Well drillers report — Engineers mesuremonts_❑, Tank, box_ es, pits, galleries 9 laterals Incoled by:Controctnr: tC Engineer: ❑ Healthdapt: ❑ , 7-- ST.CO� i I Pteld inspection' by: Health dept ❑ Engineer. IR date — — NOTES: r t� �..G H 'x 3 6 T1LEU c. �.,. r= s .1:: ,.� s •rr� �� -_e.;o APPROVED y DIMENSIONS JUL 151974 A - B BL_ _ _•_ - rr:fyM.Cou � Nwh SION OF A - O =_ ? ? =U . _B - D =_ _ _ — lhoetWM* IFIX" ewtico . A'- E IF SANITARY SYSTEM DESIGN. "AS B UILT11 f_t,��•�ytteZ,77— M-Z— c -.= EL — — — — LOCATION Strect:h���� -�;�, Town:. j ":.,3 r__+ _ :_,_,— county: D'um --,�11 — State: .!L: YuLJ Map: /6-.(, - - - -- Block•. LOT Builder:_- Surveyor:-T.-!g- Draw - Job JOHN H,'PRENTISS PE, CO NSULTING,'ENGINEER -�- e G' . 0 5 *-,Q'V4 10 ee I VrIA,�Ill- eXISTIN& 0" exi TIN& SK'(Ll&,HT Z�vqg lzv� 1 L - VLO= top- 0604 (2)-2-"412" q0lz _�2 RWO4611 gr--LOCAT� ex I 5-n SWOIN& C -A-AS5 ICCOK q FErA,4r-t,- V4leXlSl-IV.I& 12r::L0CA-re0l I 42 . . ...... . . . . . 73 O K vqe A- N I N 00 W 0 rizov1Oc- CO 5 *-,Q'V4 10 ee I I exi TIN& SK'(Ll&,HT Z�vqg lzv� 1 L - VLO= top- (2)-2-"412" q0lz _�2 -7 . FLOOP,.PLAN 5r-ALe-: 1/4'. 1'- 0" EX 15-T I N C- K6LOCATeO 4 WTA-TeO OEGIG � V-2— MICHUM CUIHIVY uuj:urwuwjv; of iwaith l7ision Of ".r.71ronmental He5lth Sirvic.. .qprovaIas fivc-oct owiforman with pplicubla Yulas ao1 ,,.,;Iatlons of the lutnam Cougly-IleaLlth Department. Pt ou,u I AVJ PAT-rr--RSotdl � y ReLOGATe FLOOP,.PLAN 5r-ALe-: 1/4'. 1'- 0" EX 15-T I N C- K6LOCATeO 4 WTA-TeO OEGIG � V-2— MICHUM CUIHIVY uuj:urwuwjv; of iwaith l7ision Of ".r.71ronmental He5lth Sirvic.. .qprovaIas fivc-oct owiforman with pplicubla Yulas ao1 ,,.,;Iatlons of the lutnam Cougly-IleaLlth Department. Pt ou,u I AVJ PAT-rr--RSotdl � y ACV 9�� s7J- l�7J�-�y7 , cb9h -a ,gh'1£ =� O ob L t� �J;9no,91-f O t ,Gh'OZ1 / r'�,Qcl ;�aLh�Oi bZ a� GTJS� Air �O/; �OoZhS r II J rico N �- 3- oG vm�- z- © ,ys-0q l� el lb. �t :try PUTNAM COUNTY DEPARTMENT OF. 1EALTA DIVISION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET' — .SUBSURFACE SEWAGE TREATMENT SYSTEM Owner J Address: �tA✓?rf �' �i,+✓,�.�: �7'"C"/z.�✓ ?✓,.t f "1 L • Located .(street): _ ►�/%�✓v��+ � . I— o✓ TM Section: Block _ • ck Lot Manicipatity:- 1 "�i�� Watershed:. SOIL PERCOLATION ,TEST DATA /O r I Witnessed by:��.. L r?!f Date of Pre - soaking; . Date of Percolation Test: !' 3 ' . J 1 11 $oie No. Run No. Time Start - ' St o p ' Elapse Time (min.), Depth to fro wat o nd m gr'_.___._ _ surface (inches) Start - Sto Water level- drop in inches r Percolation -Rate min /inch 1 10 1 O_o:'h 5 - 0 2. �. .. i 3. ` .4 y 5: 2 3 - 4 3 4.' Notes: . 1. Tests to be repeated at.same depth until, approximately equal percolation rates are ' obtained at each percolation test hole (i;e c 1 min for 1 -30 min /inch, < 2 min for 31 -60 min /inch). All data to.be submitted for review.,' 2. Depth measurements to be made from to of hole. I I/ PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES O YE NO Internal Use Only PERMIT-111 ❑ Repair Permit issued in last 5 years ❑ Not in Watershed ❑ . Repair within Boyd's Comers, W. Branch or Croton Falls Res. 9 Delegated ❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION $ TOWN C; �. -drJ TM # OWNER'S NAME O. PHONE # MAILING ADDRE APPLICANT f /`e�. 4- P S Name 8 Relationship (i.e., owner, tenant, c(ntractor 1 DATE - Ib' FACILITY PE S (/`� f / 1 CHD COMPLAINT # PROPOSED INSTALLER •ru PHONE # (�, j ADDRESS �� )46 XaS , REGISTRATION /LICENSE # /r),5.3. 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 natur arld Went of the repa' I, as owner,agree to the conditions stated on this form SIGNATURE n - TITLE DATE �J ' 13 (owner) I, the septic installer, ree to mply 'th the conditions of this permit for the septic system repair SIGNATURE TITLE 13t.lNP/ DATE (installer) Proposal approved with the following conditions: ; 1. Procurement of any Town Permit, if applicable. 2. 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. 5. No completed work is to be backfil until authorization to do so has been obtained from the Department. 7 INTERNAL USE ONLY Proposal Approved re & Title is in compliance with COPIES: PCHD; Owner; Installer PC -RP 99ML Proposal D ied ❑ A ., 10 Date Yes ❑ Rev. 2/07 Date zr, SHERLITA AMLER,: MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH .1 Geneva Road; Brewster, New York 10509 October 2, 2008 ' Fred Adams, Inc. 691 Farriiers'Mills Road Carmel, NY 10512 Dear Mr. Adams: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health J. Re: Repair Permit — Caprari & McCormick 63 Mountain View Road (T) Patterson, T.M. # 23.11 -1 -67 Review of plans and other supporting documents submitted at, this.. time relative to the above - regarded project has been completed.. The following was not. submitted with your application: 1. Field.test request form. 2: The sketch,is not complete. Please provide-sketch as stated on the proposal and Bulletin RP -1, Section 3.0 Upon. receipt of a submission, revised to reflect the above comments, this Repair Permit will be considered further. JSP:kIy Sincerely, Joseph S. Paravati, Jr. Assistant Public Health Engineer 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 Z v3H Q;;n� n8 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES THIS IS NOT A REPAIR PERMIT PROPOSAL FOR EXPLORATION OF SEPTIC SYSTEM FAILURE All information below must be fully completed prior to any scheduling SITE LOCATION OWNER'S NAME MAILING ADDRESS PROPOSED CONTRACTOR/INSTALLER PHONE # Q11-1- %b ra' (Y V ADDRESS �10 2 ` as ffo 1'M 6 REGISTRATION /LICENSE # Re son for exploration: fallure to surface q back =up In house ❑ find limits of system for repair ❑ other (explain below) FOR COUNTY USE ONLY Inspector's Signature & Title Date Jr, Appointment Date: Time: kly:excel:septic �� .ar �� � � ��a �`�z j,�h ��?��,����� - O:ai \;. R, E C E 1 �� I ED . Res`'' /o��` spa ,.Field inspection by- Health. dept ❑ do I a Engineer, —[OWNE AT :'Street H NOTES: -3 iz� C. v-, r--. 3. T. j S -r-P-- L-L-'emb" APPROVED. -00/ D -1-M-E--N SJON-S'--' WV?W-X HEALIM A' C D mm mum-. E E F 0 8 F J.- 1. 7. —[OWNE AT :'Street H e - - sot an" v L "d 4 N ;tf•; of a r � NOV -15 -2004 03 :06A FROM:'OUTDOOR CONCEPTS INC 845 -`724 -4459 BRUCE R,FOLEY Public` Health Dbvctor' TO:92787921 P.2 LORETTA MOLMARI R.K, M.S.N. Amodtate' Public Health Dtreetor • - Dlriector of Patient Servtcar ;DEPARTMENT OF HEALTH 1 Geneva ,Road •Brewster, New York. 10509 RFQ I ` tOR FIELD TESTING ATTENTION: 4JOSEPH PARAV'ATI p GENE REED. i All information below must be fi& completed prior to any scheduling. DATE: ENG.MER OR FIRM: V L PNa t Nf.m No AN. . W O- RHONE #:, g557.= IA90.0 REASON: DEEPS :. -c PERCS: ae PUMP TEST: © ' L 3 'V1 +`� ROAD/STREET: fN��d► N. i 1/i eAJ . TOWN: T p.�-I I C!W•.t 13 V-1 .'TAX MAP #: 2� • � � � (� 6 7_ _ SUBDIVISION: OWNER: N1EGr1yS ��- NYCDER CRITERU# FOR JO NT REVUW-AND WITNESSING OF SOIL TESTING YES .'NO O Proposed SSTS Within the drainage basin of West Branch or Boyde Corner'Reservoirs. ; a Proposed SSTS within 500 feet of a reservoir, •reservole stem or control,lake. D Proposed SSTS within 200 feet of 'a watercourse or a DEC wetland. O Proposed SSTS design flow greater than 1000 gallons/day or SPDES Permit required. O . Proposed SSTS for a Commercial Project: It is the responsibillty of the design professional to provide the above information. prior to soil testing. This Department will determine the NYCDEP, project status (Jolnt or Delegated) based on -the response. If you anaiwered ygf 6 any of the gnestions,.NYCDEP .must witness the soil tests. This Department will coordinate am atually suitable time for field testing with the Deslgn Professional and NYC DEP. . If a project has been determined to be Delegated based on the above response and then subsequent information indicates NYCDEP is required to witness "the s01) tests, it will be the sole responsihllity of the design professional to schedule re4itnessing of the soil testing with NYC, DEP. SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health October 2, 2008 Fred Adams, Inc. 691 Farmers Mills Road Carmel, NY 10512 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. 19ONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Repair Permit - Caprari & McCormick 63 Mountain View Road (T) Patterson, T.M. # 23.11 -1 -67 Dear Mr. Adams: Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. The following was not submitted with your application: 1. Field test request form. 2. The sketch is not complete. Please provide sketch as stated on the proposal and Bulletin RP -1, Section 3'.0 Upon receipt of a submission, revised to reflect the above comments, this Repair.Permit will be considered further. JSP:kly Sincerely, 6�� ` Joseph S. Paravati, Jr. Assistant Public Health Engineer 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 Oct 02 2008 8:15Rh HP LRSERJET FRX P•2 MAIUNG ADDRESS DATE rU I NAM WUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES L� PROPOSED INSTALLER ADDRESS TOWN Ea He4sur. TYPE TIC # 3.0407 NE # 1 PCHD COMPLAINT # PHONE # JKS' 373 �. REGISTRATION /LICENSE PMMgl (pulude a e locatlnp the hum. pry Ihtas, all adjacud wells w1thin.2t10 test of r+t pW and the location of wds" and proposed ayes" NOTE: The Department m:M7 mittal of proposal from licensed proe'essianal depending on the nature and edent of the rr -5,Allra�cr-c 'jA nfa.e-1 -ro- 1, as owner,agree to the conditions slated on -ft form X SIQNATURE TITLE DATE (ownen 1. the septic Installer. to cogiply with the conditions of this permit for the septic system reW SIGNATURE TITLE Q lUu DATE Jo- j '( prestaitar� t . Proccuemern of any Town Permit. If applicable. 2. Subrnhudw of es bulk repair sir R M by the septic system brsthNer whin 30 days of the repair, in dupe showing: a. Dmwft name, Sibs Street Name, Town and Tax Map nurnbw b. Locatbn of lrrs ded =itponertis tied to two Ixed poi is c. System descriplim (e.g., 1250 gal. Corr septic tank, etc.) d. Installers'' name and phone nwnber 9. System repair to be perlamed In accordance wish the above proposal and cordltiorrs 4. The proposed SSTS repair Is consdered a best fit design and two Is no guarantee to the duration at which the completed SSTS repair will tmcdom 5. No oorr pWW work Is to be backlilled until authorbmtfon to do so has been obtained from the Department INTERNAL USE ONLY Proposal Approved ❑ Proposal Denied ❑ Inspector's Signatwe & TWe Dace Expiration Date R r o is In compliance with Gcabie codes Yes ❑ No ❑ COPIES: PCHD; Owner, Installer PC-RP 99ML Rev. 2107 600Z /b /S, SiJoga21 dst,-Xllu-� sionpozd/uoo•luosf,qu id- ......A .sl �rM s12.4 5'- 4�' 61 -T-T 4 0, Xixew .�� *� \\\ 1 t TMENT OF HEALTH 5 � PUT . AM COUNTY &pk€ Division of .Environmental Health .Services, - Carme% . N. Y•.`Z0512 'OF ZERTIFICATE —, ,CONSTRUCTION cbmOLIANCE FOR SEWA_ GE DISPOSAL SYSTEM Patterson Town or- village Mountain V:1,ew' Rd. �1 Ches.tnut WayxaExFrled Map #186,ock I Located at t Geneva F `& Ui,ncent _Genoveserr'�LOt Wrier `30 =33 xncb.b SOII'64 Oner Separate `Sewerage System built by . HW—1 and Address N:aro1 d Brewster' NY 1250 264, 36 inch Consisting -of., Gal., Septic .Tank lineal Feet X width trench Other requirements St -10'- 01 `'Northv End Water Supply Public Supply From . k X P F B al & °Sonsr TnC Private ;Supply Drilletl :By_ ! - - Address Bre�tsters fft la _ -Four Aprf 1 27- -; 1.973 Building - Types- m. No, of Bedrooms Date Permit Is. "dq Has Erosion Control ,Been Completed Yes I certify that the system(s),as listed +serving the above, premises were constructed essentially as shown on •the plans of the completed work (copies -of which are attached); and 'in' accordance with `-the standards rules and iregulations plans filed antl the permit is ue y' the Putnam County. Department of 'Health.. 11 Jul 1974. P. X :Date % Certified by P.E..f R.A. Addr "ess R License No 69206 A'ny person .occupying premises served byAhe, above system(s) shall :promptly take such action as-may be necessary to secure the correction of any unsanitary ;conditions resulting from such..usage. 'Approval of the'.'separate,;sewerage system :shall become null. and void as soon.as`. a pubk, San itary -sewer becomes available and :the approval; of the private water'supply� shall become null antl voirJ when a' ' pply becomes available' 'Such approvals are 9 „public water su . subject-,to modification or thane when;• -in the ;udgment: of the,'COm_mis3ionec of,Health such.; revocation ,'- modification'or: change is necessary. Date /-J u BY Title: 4 �r . .. ._. r t .. _!,� -_ ,.. n •r,. _ n. ., ... _n. ..a...iy.-'S -a.,. - .... <' o :fir ..... __ _, tr.-x. t:F� r,rc_.r?..L. "F � '��; .?.sti�., n 2 i �W.- f Div r) 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 VINCENT G NOVESE ADDRESS MOUNTAIN VIEW ESTATES TOWNERS PATTERSON LOCATION OFWELL (No. & Street) (Town) (Lot Number) ' MOUNTAIN VIEW ESTATES TOWNERS PATTERSON NEW YORK PROPOSED USE OF WELL (� BUSINESS J DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL ❑ SUPPLY El INDUSTRIAL El CONDITIONING ❑ (speHER cify) DRILLING EQUIPMENT COMPRESSED CABLE ER 0 ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ (Spe (Specify) CASING DETAILS LENGTH (test) DIAMETER (inches) six WEIGHT PER FOOT 1 ® THREADED ❑ WELDED fYES ESHOE ❑ NO YES El NO YIELD TEST HOURS G.P.M. ❑ BAILED ❑ PUMPED COMPRESSED AIR f ive 15 YIELD (G.P.M.) f if teen WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) 42 f t • DURING YIELD TEST (feet) Depth of Completed Well in feet below land surface: 195 ft. SCREEN MAKE LENGTH OPEN TO AQUIFER (feet)' DETAILS SLOT SIZE DIAMETER ( Inches) FIFGRAVEL ED: 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 0 4 Drilling in overburden - earth Hit solid rock at 4 ft. 4 20 Drilling in rock - setting a n - routed 20 195 Drilling in rock - ani e If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED 4l10;` 4 DATE OF REPORT 20' WELL DRILLER (Signature) a: E3 BREWSTER LABORATORIES Box 224 - BREWSTER, N. Y. WATER ANALYSIS REPORT SAMPLE No. 3189 SOURCE: Genovese - hose bibb - well supply Mountain View Road TOwners, N. Y, COLLECTED: May 15, 1974 BY: P,F,Beal & Sons, Inc. BACTERIOLOGICAL EXAMINATION Coliform Count, MF Method This result indicates the sourer of the sample was of satisfactory sanitary quality when the samplt was collected. May 16, 1974 0 per 100 ml. a i' Vincent J. Genovese Owner or Purc aser of Building Building Constructed by Mountain View Rd. & Chestnut Way Location - Street Frame Building Type k e"a 'j ese. Patterson Municipality Mountain View Estates Subd. Section Block 10 -13 & 30 -33 Incl. 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 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 8th day of July 19 74 Signature ,�� %��G�r� Title If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP,ETION 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 Vincent J. Genovese Owner or PurcHaser of Building Building Constructed by Mountain View Rd. & Chestnut Way Location - Street Frame Building Type Patterson Municipality Mountain View Estates Subd. Section Block 10 -13 &'30 -33 Incl. 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 :Wade 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 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 syste . Dated this 11th day of July 19 74 Signature �1�fiLf/►c� Title Home Owne If 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 Lo�atea..at Mounta7 n5 Ui ew Ad .& Ches_tn� y �. SubdiJision Moun`tdfn Vi ew. -- owne, ' Geneva F.` & Ui`nce .Buildibg-Type Frame 3fV umber:'of �BedrobMs� Separate Sewerage System to cohsist of " water Supply � Public s . ' X •i Prrvati Addre Other Requnements Swale. rl represent that-4 4 rn wholly and +above ;described' will be construct -'County. Department .of`Health, be submitted to.`thesDrt epamen place m good operating conditi ance of, 'the approval of. the Ce will be Located as shown on the al Gounty Department of .Health o ;Date 4/ r `APPROVED FO;R CONSTRUCTI revocable' for .cause or may be a ;requires:a n/tew'- �'(pQ /1rmit Appro Y: �� r5 Date��� a. -Lot Area �L 1TY DEPARTMENT`�OF HEALTH • _ ?hO Health Services, '•Carmel, .N Y `10512 SYSTIk PatterSOn .Town for village ,Z! Wiz m Fi ed ,Map #1:86 A elock Y; �ot10,1.3. & 30 -33 .-Incl.: ob .501164 es e liddress 3. Center St Acre +` Brewster, NY 10509 1400 +' <(Exc1, ' Gar Gal Septic Tank Tofal AHabi2316e SPneal feet X 36- Inch width .trench ench •say ;- `` ,' r ".tAddress. s - - s ;s - completely responsible forahe design and location of the propo; d as shown on the.approved amendment there to and in accgrjdal antl that_on comple ion, `thereof,a "Certificate :of;GOnstr_uction i Ipro� nand that said well i be mstalh � Signed ON This approval expires" mended"' rrigdified when coi ved for disposal of domestic 7 0 my-.1-051Z e - issue'id unle ,the Corn mis's I /oc -pr mpliance' satisfactory to .the Commissioner of Healthwill l assors, heirs or assigns'by the; builaer,Ahhat said builder will , f two (2) years tmmediately'foliowing.the.dite of the .issu- ny, repairs ihere'to .2) that the dr,�lled_welidescribed above i the rds :rules and;.e.egu a_, -ons "of _the Putnam j License No 29206 - construction of the sbwiding has been undertaken and is per of H ealth "Any,.change;:oralferation of construction Tale 1, PUTNAM COUNTY DEPARTa ­,OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL,.N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner6 p&Aeggv ��/,��� ✓, 6;;,ovese Address �o i /ivy Located at (Street See:, �E Lot. n ica e nearest cross street) Municipality, �aerson Watershed Crea%r, . SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED .WITH APPLICATIONS - Tole Number CLOCK TIME PERCOLATION• PERCOLATION Run Elapse Depth to'Oater Water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start. Stop Drop in Min: /in drop. Inches Inches Inches 1 /D � /019 S' 1-/ 1�L. . � • 2 ioi9 iu�7 B / M )w 1-i / 2 /0/8 /o )oo 2 3/0-0 /0" I 5 � 1 2 3 4 Notes: 1) Te%td.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. "I 9 ` d .A TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLU DEPTH HOLE NO. G.L. ON 12" 18" Lo 2411 T 30" 3611 `t2" 48" 5411 60" 66" 7211 781 ,ire /4/eg 84" INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED A/on.t- INDICATE LEVEL TO WHI H WATER EL RISES AFTER BEING EN OUNTEREDA/o"e 4'Ate� 3'¢'. TESTS MADE BY P ei�c. .F. �/. . , to iB_9/_7 P_ ----.— Soil Rate Used 8 / DESIGN 0- Min/1 "Drop: S. D. Usable Area Provided "aoo' No. of Bedrooms Septic Tank Capacity 1;,4'V Gals. Type o Absorption Area Provided By y C L.F.x24" s000°— width trench. Other lvame .. .. � n3 . f. Pir 3 � aignar, Address RX, 61 clox 3,53 S L uti; THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked be H0 19_.Z6 � r1iE s�' ?SEC Structure located from survey by 'surveyor noted below2cg:� _I?j- Well located by: Surveyors survey,_ _- _ `ia • =�_µ _ Well drillers report -_ tl-- Engitreere mesurementafl. — - 0 nk, boxes, pets, galleries a I ate ra Is. Iocated by: Contractor: Engineer: He a Ith da,pt: Field Inspection by: Health dept C1 date: Eng -Ineer date NOTES: X 10 4 ( x 3 6 Tz E-� c t+ e=• s -r-, j � - SAS N A Y SYSTEM DESIGN AS QUILT° , 0WN,ER:� 2 $ hi�2.�Cst4g: -,2,- - - L -- - LOCATION Street: Town: g- rre= iSS��N- Counly:srUr. -�- S tote : �Jr2,t SUBDIVIS ION. .�a�rrLr.� Map:_ / =a. _ —_- Block•._ _ LOT N2/O- �30-33 Budder._ Surveyor :-T G, Ee�g iS�L, SS-of — 13ztws•L y�4_ Drawn Date:? I1_ 4 ScaIe:1 JOHN H, PR ENTISS PE, CONSULTING _ENGINEER JUL1 a Nf4 D I ME N SION S A - B � 'r► ��..CWNp �� A - C C ' _ — —6 r =v -WMI N OF -=il+vin+fteatw . m'.nruTM sQet�rs A O '- �2T�- -B _ D A K -^ - -B - \ \�T No OF SAS N A Y SYSTEM DESIGN AS QUILT° , 0WN,ER:� 2 $ hi�2.�Cst4g: -,2,- - - L -- - LOCATION Street: Town: g- rre= iSS��N- Counly:srUr. -�- S tote : �Jr2,t SUBDIVIS ION. .�a�rrLr.� Map:_ / =a. _ —_- Block•._ _ LOT N2/O- �30-33 Budder._ Surveyor :-T G, Ee�g iS�L, SS-of — 13ztws•L y�4_ Drawn Date:? I1_ 4 ScaIe:1 JOHN H, PR ENTISS PE, CONSULTING _ENGINEER I _ ,y r r. i rz V ter' ilZ r�s��o a'I O y'' I a t� X� •moo' �-� .. v• IM ' ..M1�(' � t ••� `' III L •, t'