HomeMy WebLinkAbout1138DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
25.56-1-39
BOX 11
lirs
.
-
me
{
I
'r6l {
kcr%
Cie,
all
rrill 16%
l�
01138
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION -OF MVIRONDEL AL HEALTH SERVICES
225 =0310
PROPOSAL FOR SEKkGE DISPOSAL SYSTEM REPAIR
aaJER's NAME PHCW
SITE LOCATION _ 3 C R tU -6,v of RtN� A,44-le TO
MAILING ADDRESS
PERSON INTERVIEWED 11'aQS GeAN J PCHD complaint # A 100
Name & Relationship (i.e, owner, tenant, etc.)
DATE' -Cr TYPE FACILITY
PROPOSED INSTALLER ! �i-�� >cI-FPc2. PHONE
Pr (include sketch locating all adjacent wells):
o�°sal
MOTE: 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.
g (LA(/ _ �. F,JS ��LC. lam ►) �`A�� I�. i
N 0 e L02 Co pr?-� In��GL� - --
Proposal approved Proposal Disapproved
Inspector's Signature &
with the following conditions:
7 t
1. Procurement of any Town permit, it 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 corners).
d. System description (e.g., 1250 gal. concrete,septic tank, three precast 6' diem. x 6' deep
drywells surrounded by one foot + gravel).
e. Installer's name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
I, as owner, or re a of owner agr' to the above conditions.
SIGNATURE i0,2 dU� TITLE
`tEg: W-Abe (?CHD) • Ye k w (Tam W; Pink (Afpliamt.)
ME 7 b - _
r,
�A 1 / 1
sW r,::;Lm� ;ro ,r;,. ,< s Car
Elmer Galloway fed. Katonah, NV 10536
JI ✓� �w pr
9/�V- ��n 0r,
Weil
.914-225-2745
914 - 232 -8888
t
DEPARTMENT OF HEALTH
Division of Environmen'; W .Health Services.
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 F= (914).278-7921
BRUCE R. FOLEY
Public Health Director
PROPOSED ADDITION APPLICATIOtiT (RESIDENTIAL ONLYI
STREET 9 OWN T . MAP # X17 , ,2 —17
- NAME PHONE I PCHD # . 3,50, O.C)
MAILING ADDRESS
DESCRIPTION OF ADDITI0N1
NUMBER OF EXISTING BEDROOMS
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM BUILDING INSPECTOR)
PROPOSED 'OF BEDROOMS
*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.
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 _ --
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #�
Non - professional sketches'aie 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
Feb 98
N
i
` R
Z MO 8
N
BRUCE FL FOLEY• P..s
Acting Public Health D if C.. t3..
DEPARITMEV\T OF HEALTH
Division Of Environmental Health Services
'4 Geneva Road, Br6vster, New York 10509
(914) 278-6130
Putnam C6unty Dept. of Health
4 Geneva Road
.-
Brewster, NY 10509
Re:
Resid60e'
(1-//7 -.2 7)
Tax Map
Tom
Gentlemen:
According to records maintained by the Town, the above noted dwelling
Js
IS NOT
in compliance Nvith To\vn code and the total number of bedrooms on record
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:'
OTHER
UL
BRUCE R. FOLEY
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINAR1, RN., M.SN..
Associate Public Health Director
Director of Patient Services
Environmental Health (845) 278 - 6130 Fax (845) 218 - 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
Mr. Vozzella
39 Ravina Road
Patterson, NY 12563
Dear Mr. Vozzella:
November 30, 2000
Re: Addition: Vozzella
No Increases in Number of Bedrooms
30 Ravina Road
(T) Patterson
TM #47 -2 -17
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 November 29; 2000. The addition is approved with the
following condition.
V,
l: The total number of bedrooms must remain at two 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 yours,
William Hedges
Senior Public Health Sanitarian
WH/jp.
cc: BI (T) Patterson