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30. -2 -25
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02145
BRUCE ..R. FOLEY.
�� � �•- Public Healthr.�Directorf .Y, of � y "j , �� � � �,•T -_msµ~ -�
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........:,LORE'�'RA •- •MO�;I1�d�ARI R.N.; IVI:S:i�t:.:..'.:.;:, ;;.
Associate Public Health Director
Director of Patient Services
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 (845)278-6014 Fax (845) 278 - 6648
Preschool (845)228 - 5912 Fax (845) 228 - 6113 November 9, 2001
Michael Pontillo
488 Richardsville Road
?Oem ey, NY 10579
/as-/ �--
Re: Addition - Pontillo, Richardsville Rd.
No Increases in Number of Bedrooms
(T)Putnam Valley TM #30. -2 -25
Dear Mr. Pontillo:
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 form this Department dated November 8, 2001. 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 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, restrictois 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 Putnam Va&e _
If you have any questions, please contact me at your convenience.
ML:Im
cc: BI(T)Putnam Valley
Very truly yours,
Michael Luke
Public Health Technician
BRUCE R. FOLEY
Public Health.. Director
LORETTA MOLINARI R.N., M.S.N.
�- . _4ssocig(e-- Public..Health. Director
Director of Patient Services
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 (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648
ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET f )6. TOWN (� �i �e�TX MAP# . -12
NAME / "1lckho ToJ;[to PHONE 45) PCHD# A -0 } C L..
MAILING ADDRESS WS
DESCRIPTION OF ADDITION / "IU� PcovyL.
'N' UMBER OF EXISTING BEDROOMS 'S PROPOSED # OF BEDROOMS_
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM BU LDING 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.
- . P!-eas_ submit this form and.thta. follo-vving to._ utnam..County- Health Dept.; 4 Geneva- Road,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 are 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
Feb98
BFhouseguidelines
BRUCE R. FOLEY
14 Public Health Director
LORETTA MOLINARI R.N., M.S.N.
Associate.. Public..Hea1!h;,DirGctpr
4
t • ,-(' O Director of Patient Services
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 (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
R
�esidence
Tax Map 3a -��- "
Town A'
Gentlemen:
According to records maintained by the Town, the above noted dwelling
IS
in compliance` with Town code and the total number of bedrooms on record is
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD. `r
OTHER
Building Inspector
BFhouseguidelines
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pU i i�6�1M COUNTY 00ARTMENT OF HEAI.T ;
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HOUSE PLANS APPROVED FOR
i BEDROOM COUNT ONLY;
• � Title
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Signature ,
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PUTNAM COUNTY DEPARTMENT OF HEALTH
HOUSE PLANS APPROVED FOR
:.. _w ... ..� �. . , •- . ., ,BEDROOM COUNT.ONL >f',
3 BEDROOMS
Signallo� -�
Date
30. -z_2S
DESIGGNIED Y��a
/0 -25-74
DES``IIGpGNIED ,,Y���`
50'-0"
Id-3" 15=(0" 7'6' 7 -6
------------
KELLY'S TO MMYJS
BEDROOM- BEDROOM
Ct
IO' 4" I� -4' 12' -8'
BEDRO•)M --- --- -- ---- FAMILY ROOM
—
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2(.'-0' Ire O V
11V .
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COURTS ARD
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DINING �'qbbm . Y
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OVERHANCa•q- ---- -
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• UTILITY ROOM N
o -
6' CpVG. '3[JCK '
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--8.Q Rcx)v C1R EFZ . r
GARAGE 5R" G
L LIVING ROOM
Nor E PREFAPC2ICATED':
FIKF P! qCE /:i /I TESTIG 4 f
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7= 0'.16=0' OVERHEAD ID b•
so- ... '. ,_ ..�.. _._..:'14-0' .._.. -- _... 7-O' ... •6.. -�a-8 5.8.. _.. 'g'-8 ° -. •- ��--. .. .. � °-
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TUTNAM COUNTY
:
Division Division ,of Environmental ti 7t
E iF,OR-:Sl
Located et tv
A1
A C_'
To �U
Lb JM 4��, 2�.A WTV
System built/ by
Separate Sewerage ' rn
Consistl qg of i c ltain'k
Z,
Other requirements
-
i
Water S p ublic SupOIV From
_z
Private' t SuP I -D.ri!1e, ci BY f YY7
Budtling °Type
H4s,Erosionl 66niroil, Bien 6onpletedn-
J'Icertify, that -,the systems) . -as 'I Mad serving O!e; pTeTjjes were _;ops.' ti
attached), and m..accordance wRh M standards rules and regulations
Date � Certified
Any person occupymg'premises ; erved n'
e a130ye, systems) shall pion
conditions resulting' feorri such `usage Approval :of `the separatese�nrei
available yand la, approval of the"private• water 'supply shall become null �Wbject:Ao.imodification or Ir`l ffi,� Wd4neri
-
" Y,r' of the; Corr
`6 at a -6
T7777777N"T
ucted essentially , as,shown.onrthe '4a
512
A N
Town , or- �illage
qdF . it�
Block _
wfldth trench
xvll�_' 11"I".11 - 1,
te,-PerWVlsiued
of',thp_'completed, work; (copies of which are
Putnam he t of .Health..
xi
PE RA
T
Lici�nse iNo."
r'rec't ion, !:of, any junsanitary.
s . ;,�oop - .�a I as . ;.a,-.p , u !J;-..�aQ . I t
pry,'-sewer becomes
hvs,`aiallibl6.-'. ",Such,., api3e6vals are,':
od caLon or change is -necessary.
� Title
... Sii A79 L' I -
BACTCRIk PER ML. (Agar plate count at 35 C).
,• -•V O•
COLIFORM GROUP (Most probable No. /lOOml.)'
HARDNESS, TOTAL -ppm
DETERGENTS- Mg
NITRATES (as N).- mg L
IRON, TOTAL = Mg /L
HMM4�N1iin r'Kl~:r� . laS N � mg /L .
These results indicate that the water was YES of a satisfactory sanitary quality when the sample was collected.
A. H. PADOV NI, M. T. (ASCP)
A t_--
Owner or urc aaer • Building
Building Constructed by
r
Location - Street
'Building Type
Municipality �—
Section
Block
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 sy tem.
Dated this 1 day of �� i 19 Signature �. ' C. r `t.•;✓� ,%��- ---
Title CW c -: U ca t"
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
WELL COMPLETION REPORT
3/71
a
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. COufaty .,,HealXh._D,ep tme,0ti,2pga beCvviSh:liboratorWrepacEof-_=- s =
^• ---snalysis f wat rSa#sipie`iYiOicail'l'ig viiater'is'o satls'factory bac'ter al'quality before certificate of construction compliance is issued.
REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION
OWNER �
�
ai�� _7
ADDRESS
LOCATION (
(N reat) (
(Town) /
/ (Lot Number)
7�
PUTNAM COUNTY DEPARTMEr
Division of� Environmenta% HWfh Services,
CONSTRUCTIQNi PERMIT F.OR SEWAGE :DISPOSAL SYSTEM
'Locaieci -•aF � -
Subdivision. DES i = 1
owner 1�.01JAL.0 1".IC �4RT�►j�
a 'Building Type r �AM W 1 Lot
Number. 'of Bedrooms /1
Separate - Sewerage System -to consist -of �'�✓ Gal.,--Septic Tank
To bez constructed by ,' 'RO1 'Fi L.4 c CA PiTN y
Water Supply Public Supply From , rx i ~ -'
Pr(vate, Sukpl y to be drilled by �� ND
Address
Ilill�M1�1� t i� AM' 1�
bA
Other Requirementsi —�ti . `� AYG ~VL'
I represent that I 'am wholly and completely responsible for the design and locatwn 'of 4h
,-a' e?de`sc will be constructed as sh -own on -the`approved'imend nent,there to and in
unty' Department•;.oi, Health 'and that'on completion' thereof a'!Certificate- of'CoKit
ie submitted to`. -the ;Department- .and, a written = guarantee will be "furnished, the owner
place';in: good operating condition any ,part of said sewage disposal system during "ah
ante . of th6'a,pprovai "of. the .Certificate of. Construciion.'.Compliance of th 'origins s�
i will 6e Ipeated as shown on the approved plan and that said well wilibe installed in a " r
t County Dep rtment of jHealth �['j /
Date 1;a '?I b Signed➢ 4
Address ( L4 C .it0.�- 1P�►y:ar! v''
tal' Habitable Space' 10 fit a Square
r f l
�l0''•-,� lineal feet -X ' Z4 width tr
dress Vi "t��"kHl4�%I�C�C11,%IL�YWly►uly F�i�3,
APPROVED FQR;CONSTRUCTION This approval expires one year from the date issued unless
revocable for cause or may be amended or modified when consider cessary by the �mmissipi
regwres ' new permit .proved for disposal of :domestic san ary ge` and /p�!(ir ate( OVn!
FDeYer / /.�. �S .By
j
4_ _
93
' satisfactory to`the Commissioner_
" r s4or. assign's by ,the ,builder, that
years.im'mediately following
s' t'h'ereto; 2):that th'e drilled
ndards ,rules and�regula io
JD Ucense No..
t+on of the building has been
— chahge ;or. alteration
only
Title
Feet
PUT1V'Ai�1 COUNTY M, PARTMENT °;zOF ~'IHEAZTH --! -
.g
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date 7
Re: Property of RomA�O MC C- A 2T)4 y
Located at y kC(4 i-iVO O Foac3T PAP ")
Section -- Block Lot
Gentlemen:
This letter is to authorize ' ICHQr"AS Is_CiA.9iC.ARIL LL.Q
a duly licensed professional engineer or registered architect
(Indicate�-
to apply for a Construction Permit for a separate sewerage system;,to
serve the above noted property in accordance with the standards, rules
or regulations as promulgated by the Commissioner of the Putnam County
Dpi artL1JQ;11t, of nedltii, a,ild to sign all rieue.ssary papers on my behalf in
connection with this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
14 Education. -Law the Public - =Health -Law- and•: the Putnam Count Sani-
tary Code.
Very truly yours,
Lr
Signed,
Owner o Prope y
Countersigned:v
Address
P.E., �a
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