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631- 589 -8100
25.79 -1 -90
BOX 13
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LORETTA MOLINARI R.N., M.S.N. T
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
August 25, 2003
Peter Mammola
21 Sharon Rd.
Patterson, NY 12563
Re: Addition- Mammola, 21 Sharon Rd.
No Increases in Number of Bedrooms
(T)Patterson, TM #25.79 -1 -90
Dear Mr. Mammola:
ROBERT J. BONDI
County Executive
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 25, 2003 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 tl>e 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
WH:lm Senior Public Health Sanitarian
cc:BI
FReceive'd 1 Geneva Road (�) 278 -6130 Brewster, NY 10509
Date 1 t? 3
of ✓� Of ALA03d"LlaR d a� -Parma. Dollars $ / ®o•ao
i For
y�0cp THANK YOU!
❑ Cash ❑ Check S?V-0. ❑ Credit Card By 5,(f /k.,L- ; ,
BFcIJCE R. FOLLY
Public Necirh Dir_ -c ;cr
D PARTMEIV—,t OF IMALT.,-i
Division of Environmental Health Services
4 Genava Road
Brerwstsr, New York, 10509
Tel. (914) 278-6130 Fax (914) 278-7921
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S3'REETro�9/ TOWS! MAP
NAME �� , Lzq'''t'� e4, PHON7F- 7� r
iti:AZIIv 0 ADDRESS
DESC'.R:PTiON OF P.DDITION.
NUMBER OF EXISTING BE13 / OOlNISa. PROPOS D . EBF R 01� s�
(MOM CUM O OC`.'LMAN -CY OR
CERTIFICATION FROM BC;ILOLNC T"SPECTOR)
t Any addition which is eons der ed a bedroom requires formal approval of plan (Constzuction
Permit ) prepared h0 a - raf.ssio:,al Engineer or Registered Arcliitect in accordance with
applicable secrions cf tht Pumam Co-xlty Santa y Code.
Please submit :his fczn: a,::d the fo :lo,xing to Putnam County Heath D,-pt.,. 4 Gereva Rd.,
Bmwster, NY" 10509, Phone 27s-:1.30.
^ 1. Certified check or money order for 5100.00
2. S�etches of existing floor plan (drawn to scale, all living area including basement)
" Non - professional skeiclzs are accepteOle
3. Two sets of proposed i:oor plan (drawn to scale, with name, street, ;)--.d tai: r^ap 9)
* Non- p.ofesssionai sket..hes are acceptable
4. Copy of survey s owin; well and septic location, to the best of your k:',awledgr,. Inc'Ude date
of installation if kno'v n: Label all W ells and septic systems within 200 feet of the p.ope� line.
Contact 'his office wi->r+ any questions.
5. Copy of Cent. of Occupancy from Town or Certi$catioa flan! Buildirg Dept, with legal
bedroom count of dwe!lLing.
OF. 1 LE U.1 -FF,
cxrlme 7s
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DEPARTMENT OF HEALTH
Division . Of Environmental Health Services
Ceneve Road, Brewster, New York 10509
(914) 278 -6130
Putrtm County Dept. of Health
4 Geucva Road
Brewster, NY 10509
C
:entimen:
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BRUCE R._FOIV.yF g
Aeting PUNIa Mealth, pi- .•I.��
Re:
esidence
Tax Ma
Town
Accotding to recc *d; mai;jtaired by the Tu„��, the abcve noted dwelling
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in compli�a'rtce v,;th To��, ;. cod- and ,rte total number cf1oedreorn5 on reco,d
is
This infoirlation ,has been obtained from:
.CERTIFICATCI OF OCCUPATYCY:
ALM'SORS RECORD:
^Building Inspector
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PUTNAM COUNTY DEPARTMENT OF HW;,�g
%OUSE PLANS APPROVED FOR
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5 REW`J7ER N.Y Io5Cx3_
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New-York 10509
(914) 278 -6130
APPLICATION TO CONSTRUCT A- WATER yWELL 4~
~I �o %5 PCHD PERMIT # U
WELL LOCATION
S 1 re t Address Town/Village/City
� ha ,ron 2d Pj finaxyl (..cL e
Tax Grid Num er
Zs• 79 -1 -o
WELL OWNER
Name Mailing Address
{}� tDa eAa ,0, (6 ox
518 MR-n►K NV
G!'Private
ib563 OPublic
ILCIE OF WELL
- primary
2 - secondary
OJRESIDENTIAL O PUBLIC SUPPLY
0 BUSINESS O FARM
0 INDUSTRIAL 0 INSTITUTIONAL
O AIR /COND /HEAT PUMP O ABANDONED
O TEST /OBSERVATION O OL7ER (specify
O STAND -BY _ :E'DtL.cL
AMOUNT OF USE
YIELD SOUGHT_5gpm /# PEOPLE SERVED 5 /EST.
O REPLACE EXISTING SUPPLY O TEST /OBSERVATION
❑ NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL
OF DAILY USAGE SUy gal
Ll ADDITIONAL SUPPLY
~
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
W CA a
/'
WELL TYPE
5?kRILLED
DRIVEN.,----/
[]DUG GRAVEL. O OTHER
IS WELL SITE SUBJECT TO FLOODING? YES �(, NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No.
WATER WELL CONTRACTOR: Name &,-a (A'-te.S Own W eJ E 60 tnc: Address: lZf J2- Cb'"hCA
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES e�S NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE- .TO..PROPERTY FROM .NEAREST.. WATER. MAIN:. ..... _ ...._ ... _ . .. .... ........ .. _.
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
318199 OON SEPARATE SHEET
(date) (signat re)
lt.il X/" 4-Z.14- a-� '-14- - -- - --
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within
thirti, (30) days of the completion of water well construction, the applicant shall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam County Health
Department attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drilling operations be contained on this
property and in such a manner as not to degrade or otherwise cont aQrd-na`fe_s—urf-ae4, or groundwater.
Date of Issue: 19
- <'C
Date of Expiration ���~}�� 19� Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
^.,Yy - + \17.r ty �,(ra�F- ,i�b ?�1'`it yy.9L�,. ',4 �` e}i i�'t t :;;4„r,t yx' : s3: ?..n'.� n`a': e1 ✓ 7JN.r�y'S4t' µi a ..� k+�d:,'.: I<; ry'Yi9x '"e is i � tM1 •R.z k,R"'w #�s;',i ly J l' ': '?''4Xk9F '� { .�+ € [YF�yriq, 4i `• 4i, r t'�,Y
44 rgv"f H.•1'-
ASR CO DEPARTMENT OF HEALTH
f E 1 H lth S
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:
Division o nviromenta ea W--L. V s
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
APPLICATION TO CONSTRUCT.A WATER.WELL
PCHD, PERMIT #
ALL LOCATION
Street Address Town Village City Tax Grid Number '
":-, �?��fnt
•tea.
'
WELL OWNER
Name " Ma111ng .:Address
1k61� ti°.1C1. xn�! a+)Gt/Gt,_ ,6 r'�Jt�n
�) „ (TPrivate .:
si. (,f -hl IC.; -N �1 .t <,�Q.3. O Public
" USA OF WELL
WRESIDENTIAL ® PUBLIC .SUPPLY
Q AIR /COND /HEAT PUMP D."AN DONED
-'� primary
® BUSINESS 0 FARM
D.TEST /OBSERVATION ❑ 0• ER (specifly
2 - secondary
® INDUSTRIAL b INSTITUTIONAL
0 STAND -BY De) -L.-
AMOUNT OF USE
YIELD.'S.OUGHT gpm /# PEOPLE SERVED . /EST. OF DAILY USAGE �b0 gal
0 REPLACE EXISTING SUPPLY ® TEST /OBSERVATION GI ADDITIONAL SUPPLY
REASON FOR
DRILLING
.0 NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL (7— iF rL Lt-
:DETAILED:
, Q400
REASON FOR
/ .. cl i,.,, b, l"
DRILLING
WELL TYPE
CffDRILLED
ODRIVENr
E]DUG C]
GRAVEL 0 OTHER
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No.
WATER WELL CONTRACTOR Names :..%�t'iPS,i�w . W X1.1. Co .r.; Address a i-;.?;
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE.:. YES NO
NAME OF PUBLIC WATER SUPPLY: .TOWN /VIL /CITY
DISTANCE TO- PROPERTY FROM NEAREST.WATER.MAIN:
LOCATION SKETCH & SOURCES OF CONTAMINATION' _PROVIDED
8 ®DN SEPARATE SHEET
(date) l(signat re)
PERMIT TO CONSTRUCT A WATER WELL `
This permit to'construct one water well as set forth above.is granted under the provisions
of Subpart 5 -2 of Part 5 of the New York State. Sanitary Code, and provided that within
thirt;• (30) days of the completion of water well construction,. the applicant shall:! ".
_.1: Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam County Health
,Department attached. to this permit'.
3.:• Submit a :Well Completion Report 'on a form provided'by':.the.Putnam. County:Health'Department..
During -all'well'drii- ling'operatioris; the.applicant shall,.take, appropriate, 'act ion•to��assure: that
:any :and all water or:'waste products:from..such well drilling operations be, contained on this
property, and in
such. a �. not .too , egr e oryotherwise ^conta ct•_- — urface or 'groundwater.
Date of ' Issue . / 't 19
Date of Expiration 19 Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
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