HomeMy WebLinkAbout1310DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
25.71 -2 -19
BOX 12
1 0 rrm v i
,.
Is 0
1 ,
as . `
01310
i
DEPARTME \7 OF HEALTH
Division Of Environnental Health Services
4 Geneva Road. Brewster. few York 105nq
BRUCE R. FOLEY. R.S.
Acting Public Health
(91;) 2i8 -6130
P,;OPOSEO AO�OITIG.N APPLICATICN _ (RESIDENTIAL ONLY
zS.�i -z-t9
S T R_E T : TOY N' TX M;P r p
F;.*:E Pr0\=12113) )9'r AV 5r7 PCHD PEMIT r /�7�"l0
me'uLING ADDRESS _ /2,il . Lea / P /� %/ �IQ �Gn �a... L r
Description of Addition 4-44o &4Z) „„ a se-cand lC /�a.01-
Number of existing bedroc- s z . proposed number of bedrooms
iron Certificate of Occupancy or
Certifi cat ion'from building Inspector
A.ny addition which is considered a b=_drecm 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 foam and the following to PUTNAM OOUYfY HEALTH DEPARTMENT,
4 GEC' ROAD, BREtiISTE , PAY 10509, Pthons 278 -6130 with tl'ie 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 . 1{ 11
Non professional drawing is acceptable •
4. Copy of survey showing wall 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 fron Town or Certification from Building
Department of legal bedroom count of duelling.
OFFICE USE
Comments and /or conditions
application
August 1995
July 1996 (Revised)
COGS -
* BRUCE R. FOLEY, R.S.
Acting :Public Health Director
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
Re:
Residence
Tax Map 157. q 6 Z�-6 `
Town
Gentlemen:
According to records maintained by the ToNNm, the above noted dwelling
IS
IS NOT
in compliance with Town cod_ a and the total number of bedrooms on record
is o�
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER
ing Inspectpr
�i® 9
\� / '
/ \� :,._.,
..,/
� \� /.
\ \� t
/� \
\� }
^� :.
\� /
\� \ �
\� \� .
£� < :. .
� � \ \.
\� � »�
� � /�.
\� � /
\�� \.
■
■
>� � �
\� \
:� /<
y� \:
� � y�.
§/� ,
. y.
� � 2�
��/
�� /.
� \� »
�`?
f � :�
/�� \
� J.
: y.
: � \
\� \
;� y .
}� � \
(�3».
*� �:
[ \� y
William Folchetti
124 Coal Pit Hill Road
Danbury CT 06810
DEPARTMENT OF BEALTH
Division of Environmental Health Services
4 Geneva Road
J. . Brewster, New York 10509
Tel. (914) 278-6130- Fax (914) 278-7921
July 2, 1998
Re: Addition - Folchetti, 232 Haviland Road
Increase in Number of Bedrooms
(T) Patterson, TM# 25.71 -2 -19
Dear Mr. Folchetti
BRUCE R. 10LEY
- ~Public- Wealth Director
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 July
2, 1998 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 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
Sr: Public Health Sanitarian
WH:tn
cc:.BI (T)
we
PUTNAM COUNTY DEPARTMENT OF HEALTH
HOUSE PLANS AP? ?OVED FOR '
" BEDROOM COUINIT ONLY;
.a ignature & Title
r
s F r r
fy ,1Z i
t rye. re s
yd
•mss
''r�,��;a:
�
IL
r
s F r r
fy ,1Z i
t rye. re s
yd
as
-...j
)
t. a
5
a s
Jt
PMAM COUNTY DEPARTMENT OF HEALTH
HOUSE PLANS APPRQVED FOR
BEDROOM COUNT ONLY;
- i
TL
Ifii�' 1�'1',. ?..Y"fa �. r, i.i? ...— .. _:i•Gs.:;'. �,.. .',•�i. �.. ry. red;/ +Lc,
Signature & Title
�J
A
eo /r ....
9.,F ea a P--- Z-
- - - -- .— •— .ads �'�
' yn�n� ,a+:•�tti;t }-- y. > ^.u,�:�'�t.?3V' �,;,.'ti- ;Jr{�.Y• fir .�:.�y.�...I�'.- \:!�,..��..., - ,,� .,•:,, - I
a ': ;. .. v.�, i"a' 7• r , °S:'t "y; "y; 1;0!!,•rrs�a•, „v,' .- ':.� "' ".• . .'' %'t "- Cr? ":�•'TaJ'�e•,•rT-•:� ,•-•t .. .,.. ... - -. ..- ..
66
1.4 . .... • Alt
'PUTNAM COUMYDEP
ARTXEgT OF
....ROUSE,PLANS APPROVED FOR
BEDRObM Coun ONLY;
Signa:tu'
re & Title'.
�� /q% A
Door
3o lee-
. I
x
Qj
N
LOT
TIITLED S "MAP EA OF PUTNAM ON LAKE�N
AND FILED AS MAP NO. 149 H
20. I ,,
S:115'55"
ILOT-";A 237 eT
i I I
�o
1 I
M M M
N N N
Q a Q
' e
160; ®' ! 1 .��� i sit
I I. 6_® moo
NM _
HAV /L° FUND DRIVE
x"Fd
N795 "
0'
Se
sets �.
/ mO
Q
N I N
Q Q Q Q e
Q Q
®
0
I. STY
LOT A 274
LOT A283
. 3 W
FR. DWG
LOT 2
30 A.C.
j
0..138 A
p
-0
IT
co
m
2
20. I ,,
S:115'55"
ILOT-";A 237 eT
i I I
�o
1 I
M M M
N N N
Q a Q
' e
160; ®' ! 1 .��� i sit
I I. 6_® moo
NM _
a
SITE LOCATION
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
EW,
Internal Use Only
Permit issued In last 5 years
within Boyd's Comers, W. Branch or Croton Falls Res.
within 200 ft. of a watercourse or DEC- maooed wetland
TOWN
--M REP)
PERMIT#
Nit,
❑ Joint Review
TM #
1
-a -l9
OWNER'S NAME V\KLQ m3 7&X PHONE# 01
MAILING ADDRESS
APPLICANT �)vJ , �` n �...m.,�A�113;0 '
Name & Relationship (i.e., owr4r, tenant, contractor)
DATE �,F\_ \O FACILITY TYPE PCHD COMPLAINT #
PROPOSED INSTALLER �•1W . 4�--t oQW� PHONE #S.
ADDRESS Vj\ka \)-, AIy REGISTRATION /LICENSE # WSS-
Pro osal (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 extant of the renair_
I, as owner,agree tot cond' •ons stated on this form
TURE I TITLE DATE
her)
- - ;the septic installer, agree to comply with °t Uec d itions of this permit for the septic system repair
SIGNATURE _: TITLE DATE
(installer)
Proposal approved with the following conditions: r
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 duplicati . 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 backfilledyntil authorization to do so has been obtained from the Department. • ,,;r`';',.'
/ h f ,.1, ;!•
INTERNAL USE ONLY
Approved „ 01, Proposal Denied ❑
iture & Title � Dfite Expir tion" ate
is in compliance with applicable codes Yes O Nt4
COPIES: PCHD; Owner; Installer
PC -RP 99ML Rev. 2/07
c�
z
H
m
g
J
CL
cc
W
0
0
ac
cr
a
m
a�
J!licnaef Desouza
228 Haviland drive
Patterson NY 12563
i
i
f
As built drawing submitted 2.17.10
Perrnit # R- 017 -1 D
TM # 2571 -2 -19
A C
Septic T
Dry Well Dow
g o0
`D
A = 29' CORNER OF HOUSE TO DRYWELL
B = 25' CORNER OF HOUSE TO DRYWELL
C = 'I8° CORNER OF HOUSE TO SEPTIC
D = W CORNER OF HOUSE TO SEPTIC
{
HAVILAND DRIVE
Faxed to PCDOH ON 2.17.10 @ 12:50PM 845 - 278 -7921
i
NOT TO SCALE NOT TO SCALE
WALL
uu 1
1 YIf_L
WALL
i
.p
NOT TO SCALE
8 p 4d
�o
I
e�
J
.y
��
IT
v
-�o f�oo` Hof
r t
FEB -07 =2008 IU.:I9AM FROM- ENVIRONMENTAL HEALTH 8452787921 T -583, P.001 /001 F464
` PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
0
THIS IS NOT A REPAIR PERMIT
PROPOSAL FOR EXPLORATION OF SEPTIC SYSTEM FAILURE
All information below must be f_ ally completed prior to any scheduling
SITE LOCATION 9# TOWN 7M # ZS-, %/ Z-19
OWNER'S NAME �'� O tLZ il{ �~ PHONE # 05' JLC "1
MAILING ADDRESS X,-fr c /.► .1.3 . _
D3 a Ito
PROPOSED CONTRACTOR /INSTALLER fL f 2eyT— -"rc - PHONE # 35'C7. l ej
ADDRESS ~f �j11(Je� �c/1�e,., REGISTRATION /LICENSE # 11 `��Viy��OiLHtRa
Reason for exploration:
El fpaftma o surface �' back -up In house find limits of �system for repf�air 0 other (explain below)
fJ 4� .c �lnei t/1ei /h et,�:.,,.�y,,.a. Ct ' Le: P�% /AAP -,
R!�l�llilll/IAlrf"'...I■Ilf�'
kly:excel:septia
0
o
aRE Pt
mw-wm"Z=R= C3 0
EL
Oy ON YN
LU
In
u
ORNwa
RLIN Rl
z
0
cim
m
—MM
WAP Jg 0
'2-
.
VIM
N v
0
NIMIA-1
��.�A�itS�.C.Y'.=
-
`'r:"h.•.i k0�i,W.
1�♦!'��
�.r'� W4,
% ON
4-
pNAFIP
Mu
"w
NOSi OV
. FA MA
Sheet _of_�
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION .OF- •ENVI-RONMENTAL.HEATLH SERVICES
FIELD ACTIVITY REPORT
eT)T)RFCC: 228 i1,dVlL, A)1> t�R,
Street Town State Zip
PERSON IN CHARGE
(iR TNTFRVTR \xlFil; 7!, /LOOT�IZ ngtP: �l ����'
Name and Title
TYPE OF FACILITY : 15.1&)a L f rAM /y Y )Z6:5 TDgAJc -� 5 5 €Pwzr
FINDINGS:
/2O'
- ! f
�. . , M.-
Signature and Title
RFPQRT RFC FTVFTI RV:
I acknowledge receipt of this report: SIGNATURE:
02/96
T
b 14
t7yNal� CoMG. 04-
Ce,.G oay. k
c�
�{B�S�
!�/G%%
I ✓exv�
Xliie- SAWS,
_ _... _:....
.. u. R. .... ,_ _ .: _... ., �._.........' fir. .. ___ �_
. _:- :.._....__ ...... .. � .. ..... :.._.. . �.....
- ! f
�. . , M.-
Signature and Title
RFPQRT RFC FTVFTI RV:
I acknowledge receipt of this report: SIGNATURE:
02/96
T
LOT 8
0.246 AC.
LOT A 226
688
LO TA23 2 °
L
i
�
N 8 N N
[Set
N a a
I.P
21.P
Fd.
i.e
HT 0470 20 E 900.00
Set
GA TES DRIVE' (8 /T
Al
40`