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HomeMy WebLinkAbout3313DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.05 -1 -48 BOX 27 03313 ' f�s*�--�'•<-- r-- '--'— ^-- +..�.� -.�- -r .. c C "� 5" •Ct r�lt {;` ' c 4 "'C'.-^-'^-..r-- t x_ � � 3� 3i Q s T x r 1F, it i � h et. � w `3� LJt l�.ar di,,. 7 T 5 y`v y. a ' ..a, v w2j� 4... .�d t' �q. v-f .t.' z` Y a =3 s r A €msstrsi a v x ` Y P,UTNAM COUNTY DEPARTMENT OF ?HEALTH k z a Division of Environmental rHealth Seraices Carme/ N Y 10512 A x Y A btV•nr 5` t�z �3.. �4"=�,, kF.y J. ..-.:� w - m •a -, 4ty_.,,�3 y CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR, SEWAGE D.ISP(JSAL ,J :,yy 1KOtxAfiQgi V�CW ROB a ji�Ip �� FLoceted; at -y�i Sectiony� w44Y.+. r�Q1g 1'iJiiY�O xt {+ f4 ,..„�ti ,t a ,. •++ ;Owner Lot J,ob 3 a �� s ,`3 h2'�8 Ct$9C�lID8t3 "� ". BOX9s PutiatII QS1�.8�� �Q•y. rF, ,Separate Sewerage System bwltYaby > °- ' Y Address' ^• — f'�, r � • Consisting o?.,. Gal septic -Tank Imeal Feet width} trench Water Supply Pubiic.supply'From ` ri et j5 PPIy\Drilled By gl�@T1�u�'Oi�flj,� @�j C'.�j171�8�TrfS ��w p C i �81e 67GLh1�8t/�b{/IKYi� ��1�1���Y•i• O•• ••�9Oy R t 4 M1� �� Address* j Bwlding' ype% ate y No of Bedrooms DOp 1i 9 T ssu�9q l • T i �. � e k 3 '�'^ "�t",3;ts-t ;.tea- 'n.�,3 ''� C : "� ��r�' r � r p `� %. `_ � O • ,. _� �.. Has Eroswn Control Been�Completed7 °F " • • ° ayi; x b G L G ', t � ¢ S �..3� .L L '} . x �. „ - -� .• � - 11'1 •- ) t_ , eY I ceitify; that :the syste map as listed serving the above premises were constructed essentially asshown on the`,plai45' f, e, c rk ��1a5of which 'attached and :in accoedance withthe standards' rules 'and, regulations plans f11ed and the permit wissued� by �t to partrA;ent of_,Mealth , ?:- -i'�') u�o JbI, %3; �7 (2 i UN`s zz `Daterr Certrfiedtby t JJ[- CP�'A R A l �L$ l r7 y +KSil' _ O:►0�{Oai�lb�IVo` ;Any person occupying premises •served by; the above systems) shall, promprtly take such action as may be nets ;nary to secure;he correction of any unsanitary. -; `:conditions resultm :'tiom such``usa a approval_ of the'aepaate sewerage system shall become null and void as soon as a'''public sanitary newer becoin;es r.., 7.; � ; > ter, 9 , ,, :, s 9 ,.,,. :. . ,.... air: r .... ,. a n. s• iayallable and !the approval of , the :private?.wateraupply.. shall become null ,and void, _when a .public swater supply becomes +available Such approvals are '.3 _, k`3 sub)ect'to motliftcat ion or change when; m the')udgment�of the�Commissioner of Healtf, such .revocation' modrfcatlort.or chahge, 1s necessary r' Y � r , T5 0. . t•- r .M tC a ITS Vol ._ .. 4'4..- *.r .. :,,.. ....� a -. .• .. 4! _ 1�,�..�9..r .._. -. .. r .. ...... 'lNt�+1�1A411:�5116.i�{i. WELL COMPLETION REPORT 3/71 m PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services " COUNTY OFFICE BUILDING - CARMEL, NEW YORK --,:.' ;es. r�(.._.: S. r - 111. -:i ,:I ;' . r n - r .,, r :� :. -L`. -. �: �'•`s re, +� viii ,a4�� - -.. _ analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER N M 'I'ICLitC -Y �'er �'i'ti�C' � ADDRESS / %'"•� f /�y�/���� "•yy` fj'li'.�X��• LOCATION OF WELL. (No. & St! . t) (Town) (Lot Number) PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ ESTABLISHMENT ❑ FARM ❑ TEST WELL F1 SUPP Y El INDUSTRIAL E-1 CONDITIONING ❑ OTHER CONDITIONING (Specify) DRILLING EQUIPMENT IPMENT ❑ ROTARY OAR PERCUSSION ❑ PERCUSSION ❑ OPe if ) CASING DETAILS LENGTH (feet) ' p r DIAMETER (inches) f WEIGHT PER FOOT j I_�" _THREADED ❑ WELDED jDRRIIVE SHOE LJ.YES ❑ NO W CASING 1 J ED? YES LJ NO YIELD T ST ❑ BAILED F] PUMPED ® COMPRESSED AIR HOURS G.P.A. YIELD (G.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE — STATIC(Specifyfeet) DURING YIELD TEST feet) f :±D.pth of Completed Well feet below Land surface: J SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (inches) FROM (feet) TO (feet) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET / e /0 t� If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPL TED1 / DATE OF REPORT I WELL DRI ER (Sign e) jy , r or Purchaser o2• buliai Bui. ing Construct by �-r !/> 4_'�L Location - Street Buildi6g Type f ng 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- C the L-1- 1iidinp, u� iliz- _ng the ,8y3t�,i?t. 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 system. Dated this d241 day of 19_Z2,- Signature Title i�- 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 d .. 1, -�i�3 ��}.Tr..lt la'•.ri'�..wR ea•.oyi'.. .YifCir. � ~.!.••M..e.. .at.r ..�n Mo. ... -. .. (a a..'+r * ^��a :�.r _ Q .e-. .y. —. ♦W .i.0:i :..•rs ..i<sf 'T V•i +: 1.� ta' . .- ••••c � +rii a < 4�. �.`•,� Jv. . \ Owner or Purchsas r of-LBuilding u � Bui ng Construct by Location - Street Municipality / Section Block Lot GUARANTY OF SEPARATE SEliAGE 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- -n -ant,. of... the- .h—ui.ldJ.n _,at, .l.j_ zing the. _ _ystem. - - - - - 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 system. Dated this 2 E- day of 19) 2,- Signature J Ti t e 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 FIrRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health weer or Purchaser of--/Building Bui , ing Cons tructE by Location - Street Bui1 i'n ,g Type j 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- }.., m-4+ the- bi i i n i i liA-.ng 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 system. Dated this ' day of 19 % "'� Signature 6` _"' ,�- '•�" Title If corporation, give name and address) THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP.TTETION 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 � 1 , II ° 8, o1 a v rs!d3r l�ixl. F Ilse S P0Y3 g4' -7.Z'; 3.G.04i 5 A,2" 38.3'' 13 2= t5.' Rfsf-aYt- Pirs 'c tit:iz ... i A4= 34•S' 134. 34,5 -' �g. iq_ % o' rY +•:oh Ass l 7' 8S= 27� �� ). r t +. n0DJOI -Ni" G L,/411; 6 yr 0%a n 2 flti y i/. DIS?` F air 3o' A -7= /% a tF3 7 56 L.or- 1 f i 2 rrT 4- .74 IV a � w 14 w6 CC r� APPROVEQ? ,mss f� ..R AUG 91972 PUTNAM CJJnI r OF HEALTH El: c ..f. BY .r.�....�n:.....rG��......RE.- - e �, i <•4 T7-DIVISION OF ENVIRONMENTAL HEALTH SERVICES;; SEPTIC SYSTEM ?i 44 r b. DESIGNED & SUPERVISED BY a °S�tl�l [ ` u ' 4" o ! 3 BEDROOM HOUSE FOR 4q ROMEO - ROMANELLI -AMIGO ° ° �` r m �y SOILS RATE _ ��- Z` l�/� �t I t i i` 111f 7 l(5,�`� . . 1 CONSULTING ENGINEERS o r "� ?-22 TANK TOWN OF PU T AIfI IFY S por3 Ov7s10,4:. UiH. 0. co. x ?.�„ O&XI' 1 NORTHRIDGE ROAD PUT /Vt) t ;14•UNTY PEEKSKILL, N. Y. NEW YORK oeo°oo ORIGINAL = J U.Ly 23 1 ri% tja.l AY r gta n; rI e? . K! y `� .CON�STRUCTIQN PERMIT�',FOR �SEWA3 4 3 � � Located at � �1Ilt�tagit'� Uiew P Patricl as 14lontagnno.° Owner z r ti �, Ms RaisedRanoh w ` Bwlding -TYpe Number of�Bedrooms rSeparate- Sewerage System to cotlASt of$ � �' To be *constructed by ` � Otto -R srWater Supply' ~Public Supply .Ffori% R :Private Supply _tobg � � £•�' �`� Sect% Lot,? ` Ada► r �xt�tt � Val,ley Town or,; VIIla9ee. ,, yz :Job �re�on Road 'Square Feet'0 I feet X` width trench'_ �egori Road Peek kill. NY z 1) tha�titaysi` tes- sewage disposal,.yitern �d a ions o °:t a Putnam te, r j� mrAiss�oner of Healtfiwill `t ! �WP ; <Lhat said builder *will .r i�e date of the "issu d _ eyl de ;cubed above � • s r I lati f the a,utnahi ` �. "� f3j ✓�Y ..ITC L�•'�^" AY pal F�4 ,� :.E.:,sr � . <'<'� .. -•i' .. .., +:�, . 3::..:, F : -..�� v � 'r -�' _5� .€fi ,:.:� �s��y�• F „E fit' II� �vrf^+ 21Z No x: *.j�APPROVED FOR CONSTRUCTION , Thls approval explres� one;•• year „fromah�date�ISSUed�unless� construction of ��` � ,i �' ' �, , T” n,undertaken� arid, Is -• ., .. �.... t ;.:.. .,.�,. , .,- K . rif >J.�.. F ._:.� . v . �.; .._rsx_a,:.a , ..,v�^c n�.:, •ra.,t.€ ,..C. •q ._ - ..:.,..—e 'str .s ::..• ' krevocable for'cause�or;may'�tie amended ormodlfled when considered necessary byrtheCommissloner ;;.oftiHealth.; �A'(�y�`C�a� �Reratlon'�of construction.• r: ✓. : ,t..J- 3`-.. r '� G r ',sY` _. psi... 4 a � '.t. ;'I - �' Sf • .vf %. � ,regwres a new .ipermlt ;Approved for disposal of domest�,ic ary se /or Nate water, supply only � � • • • � ti rDete e ^� .1' +�. ,,,F.cs ,: s w i!i„,,j �i "�TU..7 -a^ F4 rt `�.-•y °� x�'`a 3ru c,a -'!',. a.3 2� _ z'�Byx Title �- __T. � '� •, i '�wS .. s�M � ..M1. t ;�t�t1 .�ti :�'� s•u��.f+'y�� t rr.,ne;. }a ,� „. �vr°5 u1 ;�� 'a wT.. � � b�, `� ��v. r ,�F4 :� r,r tiu. �r q q Gentlemen.- Re: Property of Patricia Mont!!8nino Located at Nbuntain Vie,,r Road - Section Map 121E Block Lot 5-10 This letter is to aijithorize John SO Romeo 5,11 a duly licensed professional engineer x 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 Department of Health, and to,sign all necessary papers on zq b6half in connection with this matter and'to supervise the oonstructiori of said., system or Urd-Upral y :aoi Leh --the -p-a o-#1 -is-'- 3MA--dl, r - 147, Education Law, the,Public Health Laws, and the Putnam County Sani- tary Code. Very truly yours, Signed Countersignedo. P.E-.q RoAc # 27846 XZ Owner of Property 1196, Address U 3.2- e" 1 Northridge Road AaFfress Peekskilly .9.Y. PE Te1eph one -.,',,.' ep on (Seal 0 0. ftf 0. 1 0 01; 0 T. 0. % 0 j et 0, ..0, 0 OR 00 00 A �y PUTNAM COUNTY DEPARTNT OF HEALTH DIVISION OF ENVIRON7,1ENTAL HEALTH SERVICES -- . -i<'v ,a nu:r���� .J. ..,, .. , ...,.,...... ...<. >..rx..:•. ..,._. a. _.:�.%.... ':vam�..w cr:_i�i. r r..,- .�a�:,c. .. ...:...er. —....._� "v.':, —.,_ v.. �:�.r ...:'.6.�.: DESIGN DATA `SH8ET. - SEPARATE SEWAGE .DIS.POSAL SYSTEM FILE NO' Owner Patricia E. lontagnino Address 1196 Oregon Road Peekskill,, N ®w Yo r, k Located at (Streety ftintain view Road. Sec .Map 121E Block Lots. 5-10 (Indicate nearest cross -street) Municipality Putnam valley Watershed . Peekskill 1 SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATION Hole r -. a: Number CLOCK TIME PERCOLATIO;`. PERCOLATION Run Elapse -Depth to Water Water Level No. Time From Ground Surface in Inches. ;.Soil Rate Start Stop Min . Start. Stop -Drop in M.in/in °.drop Inches Inches Inches {1) 1 11 :66 ­1106 30 20.50 22.50 .. 2,0 _ : '15' 0 11 :36 12x06 30 - 22.50... 24.25 1.75 17.E 2: 3; (2) 1. 1107 11:37 30 22-.50 24.50 2.0 15.0 11:37 12 :07 30 24.50 26.50 2.0 15.0 I! 2 3 G 4 i 5 1 - 2 r a: 4 - Notes: r 1)..Tests to be repeated at same depth until approximately equal soil rates are ob- tained at each percolation test hole. All data to be submitted for review...`. . 2) Depth.measurements'to . be made:from:.tdp of- hole:: 1 .. , - %41, T' DESCRIPTION -OF SOILS E-:-'C-UNTE?,_D I\7 "'EST HOLES E DEPTH . HOLE; NO. - ,HOLE NO. 2 -HOLE NO. 5" Topsoil Topsoil '6" Topsoil' G.L.. 6tt -fine, -loam-. mixed fine. loam mixed fine loam mixed. . with small stones with small Stones , with small stones 12f. 1817 . . 81 . .2 4' 30ft 6 6 67t 8 iN 8 4" E INDICAT' LEVEL AT 'v,HICH GROUND �J TER IS i",,rC7'\TERE_-" None D D, A LEITL TO ',k17HICH r. �.'A T E RI-SES -AFTER RVT\ E TE IL 1 C.� T TESTS NNDEE 3"' July 109 jTl John S. Romeo. Datel. 1j, N Soy T . cz C, 16-20 Dr� 5000 — .----- S - - - - -- No F . 01-F, BQ-7-0c-:_z' 3 Ca 900 L -0 Maso!p!y 0 Absorp� on "-rea Pr' 0-vided- BYLL 336" 0 win X _LL L. F. x 2-' 10 0-, ROB 44 Ioaching pits 7.2 ft deep G AN" k ;. BRUCE • R. FOLEY LOP.ETTA...M0L- rNAR! - -F V N. ­— oc Zs aiew Public Health Director y~ Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York .10509 Environmental Health (845)278-6130 Fax (835) 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 - .JUCU 12r�4 ADDITION APPLICATION (RESIDENTIAL ONLI'1 UN 119AVAIN i ►.,a..�. .. !� ' ' - ' a MAILING ADDRESS QppLItot& O f- DESCRIPTION OF ADDITION NLINMER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS (FROM CERT. OF. OCCUPANCY OR CERTIFICATION FROM BUILDING 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. - I V2a e subriu -this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, Phone 278 -6130: 1. Certified check or money order for $100.0.0. . 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 s BRUCE R. FOLEY LORETTA MOLINARI R.N., M.S.N. Public Meallh Director "' " ` - �, ^troth; :.�;¢ ,. f. ;. ,• 3:ii.' ✓.i CCl or Director of Patient Services DEPARTNENT 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) 273 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health. 4 Geneva Road Brewster, NY 10509 Gentlemen: Re: Ira Residence Tax Map 3 e (' 4' Town 1UT N A d*.\ VA LL rt' r'Al According to re ords maintained by the Town, the above noted dwelling IS ij Ni) T In compliance with Town code and the total number of bedrooms on record 1s This information has been obtained from: CERTIFICATE OF OCCUPANCY: Z ASSESSORS RECORD: i OTHER Building Inspector BFhouseguidelines 6 s P'. .O• .Y. Z!.�C�'•.�%'•Si; +6G.4sa rF �.._ .... tsf. C..W .. 's!S~..5:'1.�..� °^Cll+w. �.t.+.V t..v LORETTA MOLINARI Public Health Director i.:'Y ^ �:•+as�w.ra -c..- e.�..i'a�+.�= .n.c�•y''i.'sCT -o, -�a� mi. —.iXw; ; uipyZ.T iti.. r. 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 Porter 31 Mountainview Road Putnam Valley, NY 10579 Dear Mr. & Mrs. Porter: ROBERT J. BONDI County Executive August 6, 2004 Re: Addition — Porter, 31 Mountainview Rd. No Increase in Number of Bedrooms (T) Putnam Valley, TM #73.5 -1 -48 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 5, 2004. The addition is approved with the following conditions. 1. The total number of bedrooms must remain at three without prior approval by this �..__._.__ _...._...._.._:._ Department. _,, iiS °G-�:Yc'i.iJi7,11 °a:'i:i, �rikFi� �iv - 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 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. ML:lm cc: BI (T) Putnam Valley Sincerely, Michael Luke Public Health Sanitarian BRUCE R. FOLEY Public clews Di ecior;'� STREE ..::_:r- .= .z3:':.i.tl.r,v'i\. t`i.;•l,'i- .J.IV. .�-.. ,. w:,.a:, Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 D 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 J 1A W W-1 0+ ADDITION APPLICATION MAILING ADDRESS DESCRIPTION OF A (RESIDENTIAL ONLY) MAPS �A : • losj N112VIBER OF EXISTING BEDROOMS_ PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR z CERTIFICATION FROM BUILDING 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. .Please submit this form and the following to Putnam County ealth 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 9) *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 f BRUCE R. FOLEY 11 LORETTA .- MOLINARI R - P b ' NeatthK. Director _ - _ - s .y : s, vra °iuh !i c °rle t?h Dire Itc �a �.vn�•`� 4. ;n::;a st1i c 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 Gentlemen: Re: IflfzTF -("-- Residence Tax Map 3. S —1-4-- Town U.T N A N \/A LL E.I-) 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: `r ASSESSORS RECORD: MI 1 re j. BFhouseguidelines Building Inspector s . a 70. 71 -1( e r3 V C h r�. %3 il�° /4 "W 5 , I i i 1 .5�1,Fe wExc S �5' /4'E 8 Zor M6. .5, G 7 8,9 00 as ,%V" on Mqq0� me. 121E nh"I"i +�� Q BuN�A4 41.ocC �mrndul ©'(14 � � TAt ,%/ Mq/o a�ct�fia� cy: CAMP LoO,CCYIT Lois Sob - 326. /a� �i� . 7fic O%F�ce c� 7iae C«,»IkJ'ekriE �ir�/ Ny , AeW 1041. Ml 74 7s ,o 0 I V 1 I C -r I'D _D TO: SAdnv�s B'C JOHN SALVATORE ROMEO All certifications hereon are valid for Ihisi Consulting Engineer & Land Surveyor map and copies thereof only if said map or e copies bear-the impressed seal of the surveyor 1 NORTHRIDGE ROAD whose signature• appears hereon. P EKSKILL, N.Y. ,4vq,por m, 1971 • TO DATE AW-1e `��^+� "`""" • GUARANTEED IN ACCORDANCE WITH THE MINIMUM~ P• E. & L. S. NYS LIC. NO. 27846X--X • TO DATE A/O 'J-Se �Omq, /O//2�7Z STANDARDS FOR.TITLE SURVEYS FOR THE W65T• CNESTEe AUD, QV71y{M ASSOCIATION. QF le g- ENCROACHMENTS BELOW GRADE IF ANY NOT SHOWN FE�510WAL LANG SURVEYOPS. s ,S .:I j. ri SURVEY OF PROPERTZ;:� FOR LEONA2D r; PATRICIA MON TAG N I N O ;b SITUATE IN THE TUMAJ OF PuTw10kM VAL:�CY POT NA M CO Q-NTY NEW YORK , J' SCALE: 1 "= 20 SURVEYED AS IN POSSESSION , (71- 28 -jej ' •` -�' LGv1, L _ S L69CblING f,rs i;. S,v DIA(ovr') x _. LT q_ TYPICAL.- SE-n C DES /6N' DATA /G- 30 „n,n. 3 BEDRoo I►1 a 9047 Gnt i 9470 S, F. Vacr» 70 - 1 8.0 av F5/Lc D14. II = 9oG sF .00 - o o- No rE5 kG3E.K:t P i T 5 <7 VC-AL 23S Y1:7nt .. . ,""'.^..'^' �� tYb.G�. .. it.bN ^.�».KoL .o d^,• d� �1 z- RE5eK /4 Plrs dveam '00' fiiOY+Y 11UJoINIrfc µltb<. - 50 /e+ QpSbkV� 3. AA.L P/rz ra IClf- A,9 0 k4WAUY; . for y. A,Sr Moir so" se. F ... _. 1 i w; s c APPROVED �s AUG � 91972 .pUTNAM COUNTY U[PT. Of HEALTH pDIV ON OF ENVIRONMENTAL HEALTH SERVICE% SEPTIC SYSTEM �$(StlgE FOR = -.aa PATR )C.lA A10A17'A(v:,V1,hi' tiYikli:C..2:.S11 -il:n -'ayi.�� 6iCL., /ER��Y A<,,.yw6.•- i.iau'S,K,l.sis- i.:y,.. w 1 1 'al.p.0 7.2• 0� ,e Tfdwk`:b - Pa ; w. ?,'.r' COUNTY OR10 _;.J ycy Z3, 1 97) NEW YORK 1E IC4)do.`l s. 9u(. // /97) SCALE 9" = 20' (-7/ -34� 7* 30 30• , /o �y C — r TYPICAL SECTI I� SCALE 1' =1 O Vc�nf o ' j Lori -20- 75- A1= 3G 131 N fNP 14'1,1 'o.00 3B•s B2� L55f 92 i + A3= 38' l33- Z3' R4= 3f•5' a4- 34, s' T" A5- 17' 85-- 27' I , 46.- 25' p86= 42,5' 4¢. ,4 7r- *5-1 h7 72L 56' A-8- /(: 882 4015' _••,•_ • _ _ _.... a+ ... �..., ............ .. ....» +%.,� ...-.. 4..ar �• .. ,., .. ... ..a _ a _ ._ _ .. `y -. •... .....- �.... ... a »._..... -,�- .. _...._ .... pPjj io~ loo ? f \ - •_� • � � I { 6 DESIGNED &-SUPERVISED BY ,•E�t�-N 0 'B£DRO;QM HOUSE ROMEO - ROMANELLI -AMICO 'a�°�'��'• SOILS`RAT$ CONSULTING ENGINEERS _ qL V1rS•001316E .ArH 8.a x 1 NORTHRIDGE ROAD ' .o (r 27846 go- ale PEEKSKILL, N. Y. •�� •.0a00 ORIGINAL=, JULY Z3, ) c" 7 TYPICAL SfcC� rttc7ty , SCALE. 1'=10'* � 3 f3+�QRoa•tit s ' 90o r, n ars L 70 7a a 8.0 av P,T 3 co:D 7 2 y Go s 9Z 3 o ��-° �` pXaC�os�,pl Or.✓N�at.;4 �sw�ii..to , } J$y 2 Res \ }'' _ Eeilp_ Alr3 9V t > l 4e, s�Cs fd: {1 liO/.t�:lN /t/G 1i/6. 5O JiPyr5' _ .¢ } f�,' a�- �' .. t - _ , _. ! 3. lacL• Alrs,� 9;.® �r %��A: E•tJw 's:' _..... . 1, Ws �- � !•n!n , � __� 111 t i i t /00. APPROVE Scw�+ylcic�ycn'y €Y z< JUL3 0,1971: ` - �¢I�,,•t• 4,L.S . , - PUT UW INTY OF NEAI DIVISION OF . • '1 .�'13 t - ENVIRONMENTAL HEALTH SOW t �n SEPTIC SYSTEM o • •• c "�/ 3y.. BEDRoc)m, HOUSE FOR DF.-SIGNED & SUPERVISED BY A ,�l/�,'Z n i 74 tl a t t yO _14 e raged .k £ern, k I/.rH�i Y 1. 4I V y Ilk S , .slk�te w�tc s �5" /4'E- 2�-ing LoT Alas. 5, -t 7 8,5t ;'io as .5/xw.a on AV No. /2 /E nhNcd BUN AZaV GOCC 6f �n 2azl f M� ol'u�fi0,7 cy' CAMP L00,000T �33 �eO) / Q;tYI `/� ��� //� ,g�rznrlt fors .306 -.328. -F-Idd ,:7 i 7/ 7Z 73 /4'W A s;• 74 7.5- .O 0 W a� a� v d /50. od _%_/4Ee s�rtc cD TS - p JOHN SALVATORE ROMEO All certifications hereon are valid for this Consulting Engineer & Land Surveyor map end copies thereof only if said map or i't copies bear the impressed seal of the surveyor, I NORTHRIDGE ROAD whose signature, appears hereon.. 4��IC. LL. N.Y. Avoor 14, 1971 • TO DATE �Se y /�� GUARANTEED IN ACCORDANCE WITH THE MINIMUM. �PeE. & NO. 27646X - -X • TO DATE `IOIISe �O,n /O//2�7Z STANDARDS FOR .TITLE SURVEYS FOR THE WH9F, CNESTF_e AMD- PJTMAM ASSOCIATION. QF ${jt;.. ENCROACHMENTS BELOW GRADE IF ANY NOT SHOWN FE5s1OWAL LANG SURVEYORS. - ,r s, r' is t f S.. @f $I SURVEY OF PROPERTY, FOR LEONARD i� PATRIC- -!A MONTAGNI NO SITUATE IN THE 8 TpWL) OF PUTMAM VAIA0 NTNAM COIj VTY NEW YORK 5 ' SCALE: ts= 2O SURVEYED AS IN POSSESSION +'C7r- z8 -7e) ,1. .S' r Am E. L: 9.0 D ,,I a v 'I x 7.2 L) fr" r ?1/d 0 ol , 77 .2!; J00, -to lk 0 APPROVED ALIG 91972 PUTNAM COUNTY UEPT- OF HEALTH Qw*&,w0lV ON ENVIRONMENTAL HEALTH SERVIM SEPTIC SYSTEM E FOR PATRICIA Al0)v-rA(3,,V1AJ0 !r Aid TOWN'OF PU T M,9M VIJ LLE Y /ki, COUNTY j u4y "Z3, 1 57) NEW YORK /97) SCALE 1= Z 0' hi-xii, Z9, /f 72. 1 6. 1 1 TYPICAL StCTi SCALF- I 101 1700 6.91 SIC qva -. goo s. F. D go L 5 Ll SE S P 11, J c-D Tarr 36.0 . ..... .. .. ... ... ... .. No rF-s R � 5 f- tz t- plr5 vllt-k- S-T a !1 1: a E 5 tr;IE Airs' oveg /00' frx-00" .., OLe. PfrZ 'rP fJ f- F8A a j2.VA U yl 1%4 10. LEA b ?1/d 0 ol , 77 .2!; J00, -to lk 0 APPROVED ALIG 91972 PUTNAM COUNTY UEPT- OF HEALTH Qw*&,w0lV ON ENVIRONMENTAL HEALTH SERVIM SEPTIC SYSTEM E FOR PATRICIA Al0)v-rA(3,,V1AJ0 !r Aid TOWN'OF PU T M,9M VIJ LLE Y /ki, COUNTY j u4y "Z3, 1 57) NEW YORK /97) SCALE 1= Z 0' hi-xii, Z9, /f 72. 1 6. 1 1 30 30 Ts+ rr t 20-1 bd �. io �-1 O _ _ TYPICAL SECTI .a . SCALE 1' =1 O J o I. FIAJA L cAr/0A14 A3= 38' l33T 23 A5= l7' BS1 27' 7 A 7= 45"1 B'7-' 5,9' 3 0 j 44 im s • �ro� DESIGNED & SUPERVISED BY 'BEDROOM HOUSE L.:.. k0MEo -R MAPIF-LLI - AM1C0'' r CONSULTING ENGINEERS r Y • `Lft9At: •Ihfi!>3C 1 NORTHRIDGE ROAD PEEKSKILL, N. Y. •���.;f'� ••�•• ORIGINAL J UI-Y Z3, I 7