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Home My WebLink About3903DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.16 -1 -44 BOX 30 r ,e - 911. , J 6-�, 9y, r, . T� - k 03903 "o 'v PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES YES NC/ Internal Use Only PERMIT # ` l^ ❑ Repair Permit issued in last 5 years Not in Watershed ❑ Repair within Boyd's Comers, W. Branch or Croton Falls Res. Delegated Repair within 200 ft. of a watercourse or DEC - mapped wetland . ❑ Joint Review SITE LOCATION -� � &00A D4 & TOWN PU U4116 161 ` TM # OWNER'S NAME �i: �•,`/'01 sS - %'Cs�l,`ty� 483,Ait W ` ONE # MAILING ADDRESS �,�, l( /v y, 105-6 7 APPLICANT d r 22.W" ;wit/ Name & Relationship (i.e., owner, tenant, c05—o?) DATE HL4&O FACILITY TYPE PCHD COMPLAINT # PROPOSED INSTALLER 7,2911,E A s rl PHONE ADDRESS -7 &q 4610"o COAA/ 1,0r�j - .IIEGISTRATION /LICENSE # Pro sal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair. 1, as owner,agree to the conditions stated on this form SIGNATURE J-0e 1 jil e(&,S k664iSC TITLE DATE 11 - f (owner) arnU —'- �. _.. �:J;Ah spy ens?aAe�r.,.enW, to.co:rply -wiiti tbP c ^Tnd tiers orthis perirrtit n the §ertic sy tern ra air �. `.._ .. SIGNATURE TITLE _ y DATE�� (Installer) /)z .- ffw - Prowl aRRam d with the following conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfill until authorization to do so has been obtained from the Department. 7 INTERNAL USE ONLY Proposal Approved Ci Proposal Denied ❑ / e nspector's Signature & Title Dat6 Expiration Date Repair proposal is in compliance with applicable codes Yes 2(/ No ❑ COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 il I 0, -. I R it LA n. G7 iJC-# WC -4149-1-191 Uc-#Pc-192 SCALE: N J, DATE:. IOC 3I jb� m PIZZELLA BROTHERS, INC. APPROVED BY: DRAW N N B Y: REVI SED: COO DRAWING NUMBER:Pg— io iff ct Fi, =; Q, AM ------------ AtT�� a 6 ur—# WC-4149-H91 PIZZELLA BR Q THERS, INC. ur—#PC-192 SCALE: APPROVED BY: ZMN BY: DATE: R Sr ED IL t- I p 04 DRAWING NUMBER: it ------------ AtT�� a 6 ur—# WC-4149-H91 PIZZELLA BR Q THERS, INC. ur—#PC-192 SCALE: APPROVED BY: ZMN BY: DATE: R Sr ED IL t- I p 04 DRAWING NUMBER: SHERLITA AMLER, MD, MS, FAAP "Commissioner of Health �.�.,_ L(�REI°ra I�oLINAELY; I2N"; tVIStV ° - ... _•�:.,,:.- :.- Associate Commissioner of Health DEPARTMENT OF ROBERT J. BONDI County Executive - = 1T68a U 1VI Iml PE Director of ®.tt e al eaEth HEALTH 1 Geneva Road: Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY (0 STREET, TYI �n� TOV6�N + 1� n�rn_AX MAP #. /(� �-( -� NAMEh,a 5i C c1'_PIIONE �/-�D��- pCHD# U- MAILING ADDRESS 5Qr)2e DESCRIPTION OF ADDITION NUMBER OF EXISTING BEDROOMS' -3LPROPOSED # OF BEDROOM (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. Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 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, to be and di' sio:�ed and•us° o� ;- a, ; -l._ oom sYecif )._(_ �_�::6 _3.e- 3.e - w..._. . _. HA -1) . .: . r ed See .,.,.�.�n Lu 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non- professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) 4. Copy of survey showing all well and. septic locations, on the subject property to the best of your knowledge. Include date of installation known. Contact this office with any questions. 5. .Copy of Certificate of Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE .. COMMENTS 5 Environmental. Health (845) 278 -6130 Fax (845) 278 -7921 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 -2841 Fax (845) 2251580 SYLZRUTA AAILEX MD, MS, FAAP Commissioner ofHealth ROBERT MORM, PE . Director ofEnvironmWal Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Office (845) 8084390 Fax (845) 278 -7921 or (845) 808 -1937 April 25, 2011 Thomas Ricapito Jr. 32 Brookdale Road Putnam Valley, NY 10579 PAUL ELDREDGE CMOEWMMW Re: Addition- A- 046 -11 No Increase in Number of Bedrooms 32 Brookdale Road (T) Putnam Valley, T.M. 83.16 -1-44 Dear Mr. Ricapito: I have received and reviewed the revised 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 April 25, 2011. 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. - _ - - -..- •- ' 'A11 plumbing fixtares musrbd updated witfi'water saving devices, i.e., new low flt I toilets, restrictors for shower heads and faucets etc. 4. This Department recommends you contact your local Building Department to ensure setbacks and other current codes can be met. 5. The approval is -for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Putnam Valley. If you have any questions, please contact me at (845) 808 -1390, ext. 43261. Sincerely, )1E It t Gene D. Reed Senior Engineering Aide GDR:cw cc: BI, (T) Putnam Valley SHERLITA AMLER, MD, MS, FAAP t, ,� ROBERT J. BONDI Commissioner. of Health * County Executive -_ ; L ORETTA MOLINARI, RN, MS1N _ ��►� . ®�� _ � _ .. , :..i�' � t*L�Or�I'�.� PT � , s.- � _ " Associate Commissioner of Health Director of Environmental Health DEPARTMENT OF. HEALTH i Geneva Road. Brewster, New York 10509 Town Lejeal Bedroom Count & Proposed Addition Status Re: Ri c ap i t o (Owner's Name) Tax Map #. 83,16-1-4.4- Address: 32 Brookdale Road Town: Putnam Valley. Year Built:.__ 1 g 5 S According to records maintained by the Town, the above noted. dwelling, is . xx in compliance with Town Code. Is not in compliance with Town Code. The Legal Bedroom Count is: 3 This information has been obtained from: _ •i.`elt, hate 6mt Viii liiZ`y: _Ad[L]_t"i nn � R9 7 5 Other: The plates for the proposed addition are considered: New Construction xxx Addition to existing house only (reconfiguring the interior) Teardowrr and /or re -build allowed under Town Regulations uav�vvava Environmental Health (845) 278 -6130 Fax (845)'f78 -7921 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 -2847 Fax (845) 225-1580 4f6'III Date / \ t . .....SeP:�....7...9......197?.. TOWN OF PUTNAM VALLEY N972- 15 6 ""4L Zone District .............R ........................ PERMIT RECORD Application` is hereby made for........!`.. CRY' .......... .............\.:............... .........................Permit Work to'start......AT ..iJlI(IE...................... Description.. REPAR... FIELDS .............. .�°........ )............................................................................................................ ............................... Location of Premises — Street or Road .......................... Rr<lokdc'3.ie .... Gardens .........................,.................................................. ..................:............ r SEC............................ BLOCK ........................... LOT ........ �14 ............ FRONTAGE ... ......................................... Depth ........................... Rear ........................... ACRES (other description) or number of square feet ..................................................................................................................................... ............................... SUBDIVISIONNAME ..... ..... ........ ..... ..... ....... . .......................................... . ...................................... . ........... .. ......... . ................................................................ :................... OWNER . Local S .... & ... Ma rIe.... liaue ... : ......... ... ...... ............................ ADDRESSRD # ,3.,....P.utnam. ... Val .ley.s. .... N....Y.. ..... 10.57.9 Dimension of Building Width Depth Stories TypeFoundation .......................... ............................... Size& Use Each ....................... ............................... Room with Window Area ..... ......I ........................ ........................................................... ............................... SewerageType ........................... ............................... Size of Septic Tank ................... ............................... Lineal Ft. Drainage ................... ............................... Sizeof Dry Wells ..................... ............................... Plumbing Description................................ ............................... Well Description................................ ............................... _. 'Additional Information .......... ................................................................................................................................................................ ............... ........................................... This application must be accompanied by a copy of surveyor's map and complete plans, specifications and all information required by the Zoning Ordinance and Sanitary Code of the .Town of Putnam Valley when requested by inspector. Estimated Fee $ ..... ............................... Building Cost $ 5 0 00..... Total Livable Area ............... ...............I................ ............ $ ............................... Sanitary. ........................ Date Zoning Board Approval ....................... ............................... $ ......... :.......................... Plumbing $ ..... ............................... Well USE CONS r ROOFING LAND 1 Family Wood Wood Shingle Paved 2 Family Steel Asb. Shingle Dirt Log Cabin Brick Tile Oiled Bungalow Concrete Metal Swamp Apartment Stone Brook Store FNDTNS. INTERIOR Lake F. Store & Apt. Stone Rooms Dams Store & Office Concrete Apt. Rooms Sw. Pools Office Blocks Apt. Ten. Courts Gas Station Brick Attic Open Garage Piers Attic Finished OTHER BLDGS. EXT. WALLS PORCHES Barns BASEMENT Wood X Front Shacks Part Brick X Side Cottages Full I Brick Van. X Rear Bungalows Cement Floor ILog X Encl. Electric Finished Shingle MISC. Phone Garage B. In. Comp. Plot Plan Furnace Field Stone Driveway Dimension of Building Width Depth Stories TypeFoundation .......................... ............................... Size& Use Each ....................... ............................... Room with Window Area ..... ......I ........................ ........................................................... ............................... SewerageType ........................... ............................... Size of Septic Tank ................... ............................... Lineal Ft. Drainage ................... ............................... Sizeof Dry Wells ..................... ............................... Plumbing Description................................ ............................... Well Description................................ ............................... _. 'Additional Information .......... ................................................................................................................................................................ ............... ........................................... This application must be accompanied by a copy of surveyor's map and complete plans, specifications and all information required by the Zoning Ordinance and Sanitary Code of the .Town of Putnam Valley when requested by inspector. Estimated Fee $ ..... ............................... Building Cost $ 5 0 00..... Total Livable Area ............... ...............I................ ............ $ ............................... Sanitary. ........................ Date Zoning Board Approval ....................... ............................... $ ......... :.......................... Plumbing $ ..... ............................... Well gy A . tic tr A51 BF 0' 66 c2V 3 Cy C 14 3t7/ PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES Internal use Dnly - r . . PER Repeir.Perinit issued in last 5 years K Not in Watershed ^' Repair within Boyd's Comers. W. Branch or Croton Faso Res. % Delegated �eR�apalr within 200 fl. of a watemurse or DEGlnapped wetland , ❑ Joint RtMew ar a c a wr` 11ON �� I� �(� TOWN L +¢N+q.+• U� //6� OWNER'S NAME J�'bit l~: Hof cs — /&-* /.'rem— �S3i?I, , ONE# )3q.. MAILING ADDRESS A-4-A ck d( ivy, -IS 6 7 APPLICANT .9 Zzy4!-' n.6!s ,YiV G Name & Relationship p.e., owner, tenant) DATE / 0 FACILITY TYPE PCHD COMPLAINT # . PROPOSED INSTALLER J�d Zz Anol . ;yc- PHONE # ADDRESS -2 11 ge -4 bd17 L470 90`i/ V- 4/'& .- *-REGISTRATION /LICENSE # Pro (Include a separate sketch locating the house, property lines, all adjacent wells within 2W feet of repair and the location of existing and proposed systen) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair. / ,�/^ 9ILb1.4f -& ,l~-/ is 1-?a/y INW- 1ktAltwr` /d. �!!' /.�!' q2#1 I, as owner.agree to the conditions stated on this form SIGNATURE Joe— IJU&6'S �WadTC TITLE "ATE (Owner)(] 1. the septic installer, agree to comply with the conditions of this permit for the septic system repair SIGNATURE TITLE _ I AA �*o. ~ (I1"W1 t. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, In duplicate showing: a. Owner's name, Site Street Name. Town and Tax Map number b. Location of i waalled components tied to two fo®d poirds c. System description (e.g-, 1250 gal. Concrete septic tank, etc.) d. imstatieW name and phone number 3. System repair to be performed in accordance with the above proposal and condipons 4. The proposed SSTS repair is considered a best IN design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work i$ to be backtll until authorization to do so has been obtained from the Department. 7 INTERNAL LOSE ONLY Proposal Denied ❑ Da r it COPIES: PCHD; Owner, Installer PC-RP 99ML Rev. 2/07 'j ' •. ,.:, .�x� EXT'6 LAUNDRY/MEGH EXT'G ROOM BATHROOM 0 F x exr� i � EX7'G �i BEDROOM U o C EXi'b GL. FX i'b e�in d i dh. window 0 L In P .III ht. 31' aff EXT'G DECK EXT'G COVERD t S � .111 ht. 31' aff DECK 36' -41" - EXT'G cxt'y 94 "NX38'h dh. rvmclo. 28' - :2. BEDROOM 2l' -4 'III ht. 9q' W, 36' -41" I�]I e oxt'q.Ildinq door I I 1 ht -3q" FFh EXT'6 LAUNDRY/MEGH EXT'G ROOM BATHROOM 0 F x exr� i � EX7'G �i BEDROOM U o C XT'G BE12ROOM EXT'G KITCHEN m ;� EXT'G DINING P$a ROOM PA s x 1 I. N I v F „ N f 0 0 O�T EXT'G LIVING ROOM m s au r 0 –1IN v I _.. _ N . O.. .. .. .... -.. - .,. ��..- ... -,. _. ..- ............ -ter a>i r ext,G 90'wu51 "h EXi'b GL. FX i'b e�in d i dh. window d.. —dory L In P .III ht. 31' aff .111 ht. 31' afF t S � .111 ht. 31' aff 0 -L EXT'G BEDROOM XT'G BE12ROOM EXT'G KITCHEN m ;� EXT'G DINING P$a ROOM PA s x 1 I. N I v F „ N f 0 0 O�T EXT'G LIVING ROOM m s au r 0 –1IN v I _.. _ N . O.. .. .. .... -.. - .,. ��..- ... -,. _. ..- ............ -ter a>i r ext,G 90'wu51 "h ext'g 90'Wx51 "h ext'q 90 "tuc51'h ext'g 90'Nx5l'h d .wlndow dh. window d.. —dory dh. wlndow .III ht. 31' aff .111 ht. 31' afF .ill ht. 91" afF .111 ht. 31' aff -L 2l' -4 36' -41" EXISTING FLOOR PLAN 5GALE: 1/8" = 1' -0" °..., FBI F a Ax*ftCtx : _ c Bu11dIo9 Tao6eglooy 8grrlaea_ :.. FRh AMM POW W I . K (914) 636-40M Fat: .., RIGAPITO /5AKALA RESIDENCE: 52 BROOK-VALE ROAD FVrNAM VALLEY, NY AA -AE JOB #: 101206 W -O" SK- 1 155UED — 02.15.11 di fp OF Y w ?a rn > O < � G m o ti --( M Z > I pli, FU I NAM UUUN I Y DtP ;A8 I MEN I- OF HEALTH o HOUSE PLANS APPROVED FOR. BEDROOM COUNT ONLY > BEDROOMS r- m ALL SUBSEQUENT REVISION /A -TERATIONS TO THESE HOUSE p PLANS MUST BE SUBMITTED ' IIHE PCDOH FOR APPROVAL f-n 44'-5� E &- Tl -'TLE DATE F- 0 210, F KA w 13� Lp I m qs Ao IM �J. INA ".-It Ao �J. ".-It MAY W