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BRUCE R. FOLEY. R.S.
Acting Pubtic Health Dare -.,z.
D��1_ \T 0; HEALTH
EPART
Division Of Environmental. Health Services
Geneva Road, 6; Ev.,Ster, New York 10509
(914) 278-61130
r P,,J=CS =D A ^0ITION: APP' 'j:,TIC�: _ f(R= SIDENTIAL ONLY)
STREET J �GC� MIN' � �'L� TX ht,P T
jell P,'ON- . 5�r 0 ^ � �� PCHD RER,tIT �4
R.,ILING ADDRESS JQI�de- ow (L ` I/�
Description of Addition c'y_Z'a510r1 o t i Fr,/7rn
Number of existing bedroc;.s � Prorosed number of bedrooms 0 •-
from Certificate of Occupancy or
Certification from Building Inspeotor
any addition which is considered a betrccr, 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 fol to P'IL F1',A4 CCUMY HEALTH DEPARTMENT,
4 GENEVA ROAD, BREWSTER, Nf 10509, Pil;r:e 278 -5130 with the following informal n...- -
Certified Check for $100.00.
2. Sketch of existing floor plan (all living area including basement, if any)i
Non - professional drawing is acceptable. co
3. Sketch of proposed floor plan.{' 11
Non professional drawing is acceptable
4. Copy of survey sharing lerell and septic location, to the best of your --
-knowledge. Include date of installation if known. to
Include all wells and septic syster�s within 200 feet of property line. Any
questions please contact this office.
5.. Copy of Certificate of Occupancy frera Tcmn or Certification from Building
Department of legal bedroom count of dwelling.
OFFICE USE
Comments and /or conditions
application
August 1995
July 1996 (Revised)
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
Gentlemen:
BRUCE R. FOLEY, .- R.S.
Acting .Public Health Director
Re: v //'
Residence 9, �,« �P�� �J
Tax Map fZ -"s - I a
To,vvn
According to records maintained by the Town, the above noted dwelling
IS
IS NOT
in compliance NvitKoNvn code and the total number of bedrooms on record
is Z
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER �r In �� s • 5 ,�i zt-Gs
4
Building InspeqKr
Eugene Mauriello
92 Wiccopee Road
Putnam Valley NY
Dear Mr. Mauriello:
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
July 17, 1998
10579
Re: Addition - Mauriello, 92 Wiccopee Road
Increase in Number of Bedrooms
(T) Putnam Valley, TM# 52.3 -10
BRUCE R. FOLEY
Pu`7ilic Healih ' 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
14, 1998 and this Department's approval stamp.
Based on the information submitted, the above mentioned addition is approved with the following
conditions:
_..
1. .numbPr`of bedfboms must rem ain -at- four^ - without priorm approval by -thin ...: __• .•..._ --. -_ . ; _:.:_ _
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 Putnam Valley.,
If you have any questions, please contact me at your convenience.
Very truly yours,
�J
William Hedges
Sr. Public Health Sanitarian
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PUTNAM COUN'T'Y HEALTH DEPARTMEW
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEDGE DISPOSAL SYSTEM REPAIR
%Q %3'yy
OWNER'S NAME a t ~ G i�J "'r i c // 0 PHONE
SITE LOCATION c IZ d PN
TO
MAILING ADDRESS $ ,4 o*i G
PERSON IN'T'ERVIEWED PCHD Campl.aint #
Name & Relationship (i.e, owner,tenant, etc.)
DATE TYPE FACILITY
PROPOSED INSTALLER r,Arva p 4.f G [s9•+S T G a. PHONE 5*, d - a 4e9
Proposal (include 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.
.S,2 2M-6 S ys
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Proposal
s Signature & Title
Proposal Disapproved
A
IYate
_Proposal approved with the following conditions:
1. Procurement of any Town permit, if applicable.
2. Sub=mission 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 agent of owner agree to the above conditions.
SIGNATURE JVA& TITLE MW � g
PM: *Ate (PAD): YeUc w (fin )1); Pink (Anlimnt)
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RFVENT FREEZING ,AND B PROON HOSE BIBS AS INDICATED ON
ii
PLANS.
11 ,su
INCLUDING SUPPORTS' W NO
LONGER NECESSARY. CAP AND MAKE SAFE REMOVED DISCONNECTED MATERIALS
BELOW FINISHED SURFACE&,
8: PLUMBING / HEATING CONTRACTOR MUST LAYOUT HIS WORK IN ADVANCE OF,NEW
CONSTRUCTION VERIFY REQb. 'arARANCES TO AVOID UNNECESSARY
4 CUTTING
LOCATIONS OF ?&t,PT.PING.,T6 BE VERIFIED -,ZTi7H-OWNER PRIOR TO
9.11. HEATING SYSTEM .... ..
SHALL BE CONTRACTOR
LAYOUT DRAWINGS�.AND sprts. ToARcH
TO SUBNGT ItEcr PRIOR 'TO FABRICATION AND
INSTALLATION AND TO VERIFY DIFFUSER :kN6, RETURN AIR GRILL L6cXTNs. 'PLo6R
.
iFFU'SSERGRIIT
SHALBFS�f SYSTEM BE. PRO-P,ER LY BxtAN Cjs
D D
IO.FLrCnUCAL CONTRACTOR "tb,V,gkIFY CAPACITY OFiL l.tMGPkOVbE"—' GALLON ABOVE
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GROUND PROPANE TANK WHERE SPECIFIED. SYSTEM TO BE MERCURY TESTED AS PER
CODE.
11. ELECTRICAL PANEL AND TO PROVIDE ADDITIONAL SUB - PANELS - OR
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UPGRADE TO A NEW MAIN PANEL AND SERVICE AS REQUIRED. CONTRACTOR SHALL
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PROVIDE GUARANTEE FOR ALL MATERIAL. AND WORK FREE OF DEFECTS FOR (1) FULL
YEAR FROM DATE OF FINAL PPROVAL /ACCEPTANCE OF INSTALLATION. PROVIDE
FREE ADJUSTMENTS, REPLACEMENTS AND CLEANING TO MAINTAIN SYSTEMS IN TOP
WORKING EFFICIENCY. OWNER SHALL BE FULLY INSTRUCTED, AND PROVIDED
-%T,=N INSI*RUCnONS IN THE PROPER OPERATION OF THE SYSTEMS.
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