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631- 589 -8100
91.32 -1 -39 & 91.32 -1 -40
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MAR -25 -2004 THU 09;00 AM PERSICO CONTRACTING FAX NO, 9146640507
PUTNM4,r.,oL N7VHEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
rR& L. FaR SEWAGE DIS�'_OSA,i U CTII;N UE
OMCML USE ONLY
31TE LOCATION
OWNER'S NAME
MAMING ADDRESS.
T�.
_PHONE �tl�f - 76o -7�Qb
PERSON INTERVIEWED Zee U; # of 1 J QigN PCHD Complaint #
As e & Keumonsmp i.e., Mier. 10m; etc.)
DATE 3-13 -01 T8?E FACUTY
649ov- %.r13
PROPOSEDINSTALLER
ADDRESS '21l 44,
REGISTRATION#
P. 02/02
/ 7.43' 7Y6 -aJP
Pte, (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 vegistered architect,
` r
:aft'
I, as owner, or reporte ent of owner agree to the conditions stated on this form.
SIGN�Z�� T177 P F ___ DAZEr� -.S
Proposal 1wur'QY the- folloY iM cconditons: V
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
e. Installers' name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
Proposal approved
Inspector's Signature & Title ATE
COPEES: White (P'Cl3D); Yellow (Town BI); Pink (applicant)
PC -AP 99ML
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PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEWAGE DISPOSAL SYSTEM RE-PAIR
OFFICIAL USE ONLY
R I �
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SITE LOCATION O Eio /EST L petok sk I ( &i4 3M#
OWNER'S NAME LEV r�Q3 .,g Vi miu PHONE 171Y- 76o -7696
MAILING ADDRESS
PERSON INTERVIEWED Leo U: # o/ i v Q&wgr PCHD Complaint #
ame a ations ip i.e., owner, tenant, etc.
DATE 3- 13 -o5 TYPE FACILITY
9��8oy 9 ri3
PROPOSED INSTALLER Ao saa J- . Sys o�L,�,a� PHO 2= 3, 7K6 -ter.
ADDRESS `I &CIL JeA4AJ !�� REGISTRATION#
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.
E(1 dk, 104o %Ai�V w � l gcj a� lt74 � �4/'1 . iINF�� 1 �2840r
+a�roa -1 l AJ-1EJ �+ A k II-Alm. 127 , �1/9S' 5160- 9- k(.x2i Vf Area, l3i} &b a,.+
-,I,.-as-owner,-or reporte - gent of owner agree to the conditions stated on- this -form. -
SIGN TITLE.. //
�.V'
Proposal 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
DATE Y "
b. Site Street Name, Town and Tax Map number.
C. Location of installed components tied to two fixed points (e.g.,house comers).
d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep
e. Installers' name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
Proposal approved/
�l
Inspector's Signature & Title
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
PC -RP 99NiL
DATE
R
LORETTA MOLINARI k.N., M.S.N.
. Public Health Director
DEPARTMENT OF HEALTH
I 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 '
'ROBERT I. BONDI
County Executive
F:A.CSIMI L-AE TRANSMITTAL
0
To Fag• %
From: Date: `>
-
Re: .. ..- Pages: . .
CC:
C3 'Urgent C3 For Review ❑Please Comment ❑ Please Reply
r— ///7 / /// � /Q• {/ ter.+ /1 __—
CONFIDENTLALUY STA.TEMENT:. The information contained 'in this facsimile may contain CONFIDENTIAL
and legally protected information intended only for the use of the individual or'entity named above: If the reader of
this- message is not the intended recipient, you are hereby notified that any dissension, distnbution, or copying of this
telecopy is•Strictly prohibited. If you 12A received this telecopy in error, please immediately notify us by telephone
(845- 278 - 6130} and destroy all documents associated with this facsimile.
MAR -19 -2004 FRI 10:52 AM PERSICO CONTRACTING
LOUTTA MOLINARI
Public Health Director
FAX NO. 9146640507 P. 03
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 1 0509
Eavirantnental Health (645) 278.6130 Fax (645) .,78 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278.6678 Fax (845) 278. 6085
!Early InterventionlPresehool (845) 276 - 6014 Fix (845) 278 - 6648
SEPTIC SYSTEM WSTAI LER REGISTRATION FORM
ROBERT ]. BONDI
t;,osrnty Executive
1
Business Name IM QA7iG EX[AV LW Owner." iwt1'' �/
etc fit/Ar�
Business Address ZI J (-re Ff LAS Business Phone 9/y - soy • 015`13
V_& AAN /U. l n c j Emergency Phone loJ- 7 F,=? o -
Fax Phone.
Tax I,D. # (*,g- I i ,j 8 7 — - -
Service Pro ided
SQ v3h5dd i117 Ow
`kgrkers',Compensation Carrier Policy#_ __.Expiration
Date
Corporation or Inc. (Affidavit required) ' /
President A Aa 6,W, WA V:P, i 1Cc ?1 ow er
Treasurer, _ Director
I, as owner or agent, agree to follow the regulations, procedures and policies of the
Putnam County Health Dept for the installation and repair oi: subsurface sewage
treatthent systems.
Sign re.
Title {/ �- Date_ S-15' dY
Approved
Comments
septic installerformlpm 1116103
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PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEWAGE DISPOSAL SVSTEIVI REPAIR
f G OFFICIAL USE ONLY
ATION i• �%I��JL�' .D. TM# q /, 3� -- 3 %� 0
NAME GE t� ji , '-rn0— 0 PHONE e7C y
ADDRESS Z-AA2E P£F.K.S4 LL hit y 10 5-3 Z
PERSON INTERVIEWED PCHD Complaint #
Name Relationship (i.e., owner, tenant, etc.
DATE / 1 Aq � �? TYPE FACILITY 6FJgS
PHONE .5�� ° ,-Z 5 6—
tRATION# (2C-
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.
I; �s owner; o re orted agent of owner agree to .the conditions stated.on this ,form.
SIGNATURE V TITLE A�Pi!ti 7 DATE
Proposal 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 comers).
d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep
e. Installers' name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
Proposalapproved
Inspector's Signature & Title
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
PC -RP 99ML
DATE
a
LORETTA MOLINARI
Public Health Director
ROBERT J. BONDI
County Executive
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
Leo & Debra Vittorio
31 Johnson Street
Lake Peekskill, NY 10537
Dear Mr. & Mrs. Vittorio:
December 19, 2003
Re: Addition- Vittorio, 61 Maple Rd.
No Increases in Number of Bedrooms
(T)Putnam Valley, TM #91.32 -1 -39
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 December 2, 2003. The addition is approved with the following conditions:
1. The total number of bedrooms must remain at two without prior approval -by this
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
William Hedges
WH:Im ✓ Senior Public Health Sanitarian
cc:BI(T)Putnam Valley
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In
4�- @'.�:j �i �. .. _ .y, ... !: - .im ` >�S� -1 ..ei�- -.p+rV r. .�L✓. F.. '♦ ...
LORETTA MOLINARI
Public Health Director
ROBERT J. BONDI
County Executive
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
Leo & Debra Vittorio
31 Johnson Street
Lake Peekskill, NY 10537
Dear Mr. & Mrs. Vittorio:
December 19, 2003
Re: Addition- Vittorio, 61 Maple Rd.
No Increases in Number of Bedrooms
(T)Putnam Valley, TM #91.32 -1 -39
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 December 2, 2003. The addition is approved with the following conditions:
1
N
The total number of bedrooms must remain at two without prior approval by this
-.department.-_7--;..,..:.-
The area of the existing sewage disposal system, and its expansion area, must be
maintained.
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 you-
William Hedges
WH:lm Senior Public Health Sanitarian
cc:BI(T)Putnam Valley
N
pBRUCE R. FOLEY...
b'
`�hrL'Qltlt ^'®i%'ecl6r O'p •i. .. rai its -i .
f . -. -Z . LOIcET1r1 °1V10TIi`1ARl RN.,- M.S.N.
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 Preschool (845) 278 -6082 Fax (845) 278 - 6648
ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET L I�G� N . TOWN ' _ I MTXMAP #�`'I - 3q
NA PCHD# � �
MAILING ADDRESS J
DESCRIPTION OF ADDITION c:AicLb -5E R4 R(Z PO CH i6 F l-fir 'F ',AOt�jtti'1
_:4D—c a u t✓t L; C0 %Tc: t-(CfJ -5()Act
\rLti1BER OF EXISTING BEDROOMSL_C�- PROPOSED # OF BEDROOMS c;.
(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., 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
Khouseguidelines
'V
w� : -BRUCE R. FOLEY
Public• Kealth„ Director
LORETTA MOLINARI R.N., M.S.N.
:-;4jS( f face . ublic: Health' Director°``""' `
Director of Patient Services
- DEPARTMENT OF HEALTH
I Geneva Road
Brewster, New York 10509
Environmental Heilth (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: 4rTronip
Residence
Tax Map 91. _S 2-- 1 —3S (� i Ma Pz_c S�:J
Town UT rJ,A m ACL a
According to records maintained by the Town, the above noted dwelling
IS v
JS NOT
in compliance with Town code and the total number of bedrooms on record is
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
I,,/
ASSESSORS RECORD:
NNW*,
Building Inspector
BFhouseguidelines
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MASTER BE.
LINEP
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CLOSE
BEDROOM
EXISTING ROOF OV
EXISTING CONDITIONS
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24'-0"
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FOUNDATION PLAN
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