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36.40 -1 -13
BOX 18
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02023
ALLEN BEALS, M.D., J.D.
Commissioner of Health
ROBERT MORRIS, P.E., MPH
Director ofEnvironmental Health
September 3, 2014
Cody Barticciotto
547 Lakeshore Drive
Patterson, NY 12563
Dear Mr. Barticciotto:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390 Fax # (845) 278 -7921
Re: Addition Application
547 Lakeshore Drive
(T) Patterson, TM 36.40 -1 -13
MARYELLEN ODELL
County Executive
This Department has reviewed the documents for and has discussed with the Town of Patterson
the above referenced application. Based on the information provided, the existing house
constructed in 1940 is in compliance with Town of Patterson Code. Since there are no issues
with the town code and all construction is legal, this Department has no jurisdiction in this matter
and no application is required to be made.
Please contact us if you have any questions.
Very truly yours,
OsJeph S. Paravati, Jr., P.E.
Assistant Public Health Engineer
JSP:cml
SHERLITA AMLER, MD, MS, FAAP
Conimissidner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner. of Health
ROBERT J. BONDI
County Executive
ROBERT MORRIS, Pt
Director of Environmental Health
..DEPARTMENT OF HEALTH
I Geneva Road... Brewster, New York 10509
ADDITION APPLICATION RESIDENTIAL ONLY
STREET
—-TOWN �,�TAk MAP #,-201
0— ; 0& T
NAME j�� PHO
PCHD#
MMLING
ADDRESS
DESCRIPTION-OF
ADDITION
#
NUMBER OF EXISTING BEDROOMS PROPOSED # OF BE'DkOO19 tj
(FROM CERT. OF OCCUPANCY OR PROPOSED
FROM BUILDING INSPECTOR)
"Any addition which is considdrecf a bedroom requires formal approval of plans (Construction permit) prepared by
M rd
a Professional Engin&r or Registered Architect in accordance with applicable sections of the Putnam County
Sanitary Code.
ii'6is f(inn -anithe-following to-Putnam County Health Dept., 1 Geneva Rd,
Please submi a
:.Brewster, NY 10509, Phone: (845) 278-6130.
1. Certified check or money order for $100.100,
2..' Sketches of existing floor pla*n (drawn'to scale,, all. living area including bas6men4 to be-
'.*shown and dim6nsi6ft&d and use 6f each _i6__'
room tion 3.c of Bulletin
HA-1j
Two sets of proposed floor plans (drawn to scale = with name, street and tax map
Non-professional-sketches are acceptable and preferred. (See Section 1d of Bulletin -
HA -1)
4,!:. Copy of survey,. showing -all well and septic locations on the subject property to the best
I . . . .. . I V y
of your knowledge. Include date of installation known. Contact this office with any
.5. Copy of Certificate of Occupancy from the Town or Certification from the Building-
Department with legal bedroom count of dwelling.
-0 VOCE USE
COMMENTS
5.
Ehvironiftental Health (845) 278-'6130 Fax (&45) 2.78-7921
Water Supply Section (845)225 . 'S18,6 Fax (845)225 -5418
Nursing Services (845) 278-()558 Fax (i45)278_6026
Nurting Home Care Fax (845)278.-6085 WIC (845)27&16678
Early Intervention*/. Preschool (845)228-2847 Fax (845)-225 -1580
COG
SHERUTA AMLER, MD, MS, FAAP y� 3 ROBERT J. BONDI
Commissioner of Health * County Executive
LORETTA MOLINARI °M MSN` !ji Y R ROBERT MORRIS, PE.
Associate Commissiongr of Health Director of Environmental Health .
DEPARTMENT OF HEALTH
I Geneva. Road. Brewster, New York 10509
Town Legal Bedroom Count & Proposed Additioii Status .
Re: (Owner's Naive)
Tax Map #_
Address: ! Zz '� /�`/
Town :.
Year Built: 4414
According to records maintained by the.Town, the above noted dwelling,
is in. compliance with Town. Code. ' Q
Is in compliance with Town Code, dl `4A
a
The Legal Bedroom Count is:
.This information has been obtained from:
Cei icate of Occupancy: ,
Other:'
The .plans for the proposed.addition are considered:.. r'
New Construction
Addition to existing. houpe-only+
Teardown and/or re =build allowed under Town Regulations
.. pector
6.
Environmental Health (845) 278-6130. fax (845) 278 -7p21
Water Supply Section (845) 225 -5186. Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026
Nursing Home Care Fax (845) 278.-6085, WIC. (845) 278 -6678
Early Intervention % Preschool (845) 228 72847' Fax (8.45) 225. =1580
eS
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ar
ROOM
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17.1
,OWNER'S NAME
" " pROPOSI,' F'OR:iC�E DISPOSAL SYSTEM REPAIR H ✓' O <---,, :.
idle. e MR6 . 5ALVATog E aJ, 41- /OTTA
PHONE 2 71- 45o 3
SITE IACATION 5.47 E= L A�C� �JKOl�1� �� . � $121r tn15TG R � N `t� fit$ POT I-k w 5 1321-13z¢
MAILING ADDRESS 5/} M e
PE RSON INTERVIEWED /V IA PCHD Canpl.aint # N`A
Name & Relationship U.e, owner,tenant, etc.)
DATE 4P&O 1 L. Zo , / 9 V-6- TYPE FACILITY R E5- /DEN 'T /A4
PROPOSED INSTAIpM YR V E'S i4 e f,4y1''78/n1 �j l PA VIP 414 L / g�� g3 o PHONE 27y- 56 5 ,3
�1 S • i
ncl
� (i sketch locating all adjacent wells):
NOTE: 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.
'Ti46' FROp6.5E-77 -REPAIR WILL VT/L-126- ?HE
SEPTIC TANK (WHtcH WILL
Ti-f E 1= X /5"r/NC EAGN /it,'d P'1Q-PJ AW44C NAS F"A /1- ELF %4A.) IL L_ E
137� pig 5 P THE c-Lgwg w4-t-��/2 9rF1- ij Ed7, FAom THE ScP-rlG %/#NK
WJI-L .i$�NA2C;F /IJ iO iP41 i- - 6�,u?p A „P° i3o�
1//YPE -9 /VOAM)04 e ®/VD /7 /0NS 714E WILL Avg 114-rl) A POM, -iNG GFlatrf3EC
AN y 86 4-1FiE y INTO /+ -�€'eoivD J1 ,8t)x t yi-IC4 - /T WILL F P16TKiB(lTEp >n> ?0
- 7H►2Ef- RoW-! 5,- ':KA)PILTRA -roR `0 LEAG,f /N t/ GHAel (IE-45 It AWA)fa A COMBiN67D
GAPAOI Y 09 966 C, fli.i.��uS � /f3 rT!j of &5vRrAcE 4RE-I) , /N 7'Ngr 6VE -Al7'
P_06ve c .1�11T13C�1r :DK - P_iliM1? Pr41Lii1 ?IfE E iUC< -�y.
A P41P_ or' '�Nf�ILTIP.fI'%o2' LC,4CN 1+u4 Cl�i�d^�g�,�;S . €€ /4-r—t s}GdICT>
Proposal approved Proposal Disapproved SktToilJ�
's Signature && Title hote
roposal approved with the following conditions:
1. Procurement of any Town permit, if 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 reported ag t mer agree to the above conditions.
%NSTAL L E-e
SIGNATURE i` TITLE ��C,l j Zo v.
PUS: White (MV); YeUjow (fin HE); Pirk (A*liam t)
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—�HOWN ON
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TOWN OF P,47-ERSON
PUTNAM COUNTY NEW YORK
SCALE 1":-20.'
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1, James C.-. Edge! , the Surveyor Who mode
Mis, rzzjp, do I)Cf-ebk,. certify lhot Ike survey
or tbq-*propor!y - shown betoo'l W05 complelad
February: 24,:,1965.
IV Yvrk 4�-easp
C2111/1, RagiYlrulicn N-95630
Office 0f C. Edgell
L anti Svrveyors
93 Main SIr, L'.1, 8rewsler, AVw York 'oh iver
3510
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L -S,1,321-134`4h`VCL.
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—�HOWN ON
' 7 �114R PUTNAM LAKE
TOWN OF P,47-ERSON
PUTNAM COUNTY NEW YORK
SCALE 1":-20.'
SUi,,j (ile
,,-/ 41e)IlCh A- t4 9
DRIVE
1, James C.-. Edge! , the Surveyor Who mode
Mis, rzzjp, do I)Cf-ebk,. certify lhot Ike survey
or tbq-*propor!y - shown betoo'l W05 complelad
February: 24,:,1965.
IV Yvrk 4�-easp
C2111/1, RagiYlrulicn N-95630
Office 0f C. Edgell
L anti Svrveyors
93 Main SIr, L'.1, 8rewsler, AVw York 'oh iver
3510