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Home My WebLink About1069DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.49 -1 -20 BOX 11 If 01069 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR )� Internal Use Only J ❑ ❑ ❑ 19 ❑ Repair Permit issued in last 5 years Repair within Boyd's Comers, W. Branch or Croton Falls Res. Repair within 200 ft, of a watercourse or DEC- mapped weU ❑ Not in Watershed ❑ Delegated ❑ Joint Review SITE LOCATION TM OWNER'S NAME acj< � a` r (, °� ��,.- PHONE # �7 �% _0 53 MAILING ADDRESS j p S -041 EVA20%01 '� SG APPLICANT r �' , e c- i r' Name & Relationship (i.e., owner, tenant, ntractor) DATE / D FACILITY TYPE PCHD COMPLAINT # PROPOSED INSTALLER PHONE # ADDRESS REGISTRATION /LICENSE # Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed trenches) NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location and proposed pump systems will require submittal of proposal from licensed professional I, as owner, or reported agent of owner agree to the conditions stated on this form SIGNATURE TITLE Proposal approved with the llowing 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 d. System description (e.g., 1250 gal. Concrete septic tank, etc.) e. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions. Proposal Approved ,/ Proposal Denied 3 i3 Ica Inspector's Signature X Title Date COPIES:. White (PCHD); Yellow (Town BI); Pink (Installer), Orange (Applicant) PC -RP 99ML Rev. 8/05 DATE 1 Robert J. Bondi Cris Dellaripa County Executive Septic Repair bupxtor Edward A. Barnett Mlchde Palermo Wmersbed Itdbrmation Coordinator Office Manager PUTNAM COUNTY SEPTIC REPAIR PROGRAM '.L V la104 100 Rte. 312 — _ _Bldg. #4 Brewster, NY 10509 D o � I b p < t �- r , --Q, l w I .ki 1 9 S 0 3 S1 c ti C, o"o P v -� La �� e �� . i j i 1 9 S 0 3 S1 c ti C, o"o P v -� La �� e �� . i q. �R y� (8' g-3 Robert J. Bondi _; ; Cris Dellaripa County Executive Septic Repair Inspector Edward A. Barnett Michele Palermo Watershed Information Coordinator PUTNAM q /lalo6 Office Manager 4 ' N'TYY SEPTIC REPAIR PROGRAM 100 R Bldg. #4 Brewster, NY 10509 a _ V/" c 1� 1 4 v S Robert J. Bondi .._: �' Cris Dellarips a, /o V County Executive Septic Repair lnq— Edward A Barnett Michele Palermo Watershed Information Coordinator Office Manager PUTNAM COUNTY SEPTIC REPAIR PROGRAM 100 Rte. 312 O Brewstet� NY 10509 L J Y r � I `C o d5 � --Z I w I sv - wC)()- ;i C S m W 1 0 3 P�-� L0. fW. Y' Vim' `^ • `plp \ DRIVE r7rrJG _ _ Olo . br CoK I �,jD f Gr .g1EX�l6LL t i1,1h l04 IN . 5 " R lit 48`. 07` aouaN 5&,-vg E E�Z.s. 1/'37212 Y, •' b . SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive n l� ADDITION APPLICATION RESIDENTIAL ONLY G d TOWNJ2ZZ-��TAX MAP it /�. �/ HONEAJJ,C.3�e PCHD# r 21% W--,4 DESCRIPTION OF o� ,f- Cx s� N �- &V.A-,*< t two LI U, N 6- RAt ,, �+ 10V�41�i,014 t-L rAm' F PKiST nt. 77 SIM9. -Lo SM6-T1L l l`�IDI? 1M W�o V&WW,- f NUMBER OF EXISTING BEDROOMS 3 PROPOSED # 0. F BEDROOMS O (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.) 278n6130... _. 1. Certified check or money order for $100.00. 2. Sketches of existing floor plan (drawn to scale, all living area including basement) 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 locations 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 Certificate of Occupancy from Town or Cert ification from Building Dept. with legal bedroom count of dwelling. OFFICE USE COMMENTS • 9 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 ' Gam. SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 1050.9 PUTNAM COUNTY DEPT. OF HEALTH 1 GENEVA ROAD BREWSTER, N.Y. 10509 To Whom It May Concern: ROBERT J. BONDI County Executive RE: �7 Reside e TAX P4 ' 4•S TOWN According to records maintained by the Town, the above noted :dwelling: IS IS NOT IN COMPLIANCE WITH town code and the total number of bedrooms is, 3. This information has been obtained from: CERTIFICATE OF OCCUPANCY ASSESSOR'S RECORD OTHER MrA907-011AS 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 n, P. DEPARTMENT OF HEALTH Division Of Environmental Health Services .1 Geneva Road, Brewster, New York 10509 (914).278 -6130 HOUSE ADDITION /REPLACEMENT APPROVAL GUIDELINES I. The Putnam County Department of Health must review all proposed additions, which will result in an increase in living area. A. Any addition which is considered a potential bedroom requires a formal approval of plans (Construction Permit) by the Department -and plans are ..to be prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code, unless system -is presently designed for proposed number of bedrooms. Plans will provide for.the installation of additional and /or new sewage disposal area meeting present code requirements... B. The determination.of_ whether a proposed room addition to a house is considered a bedroom will be made by Department staff based upon: Location of the room in the house - Size of.the room 1. Accessory rooms such as Dens, 'Libraries, Studies, Computer Rooms, Offices, Sewing Rooms; etc. may be. considered. potent i.al bedrooms. _... _..____ .__...... ..2_.._--Large- -bedrooms•, which may easily -be divided "by :a, partition Wall', 'may be considered two potential bedrooms. 3. Storage areas-or unfinished portions of the addition may also be .considered potential living area. C. Any addition which is not a bedroom will require the submission.of a plan prepared.by the property owner (to scale) showing the entire house floor plan exi.sting and proposed. The determination of what constitutes 'a potential bedroom will be made by Department staff, i.e., an' office 8' x 8' may be considered a potential bedroom. Once the review has-been-. completed the plans will be stamped noting-the number of bedrooms, including potential bedrooms. If the number of bedrooms remains -the same.- as existing; no further expansion of the sewage disposal system will be required. If, however, it is determined that any.increase in potential bedrooms is proposed then refer to' "A" above. A letter from the Department will be issued indicating total number of existing bedroom's and no expansion of'sewage disposal, area will be required and any other permits or variances. required are the jurisdiction of the Town. � O II The Putnam County Department of Health will allow the replacement.of-an existing residence utilizing the existing sewage disposal and water supply for the following reasons: A. Hardship due to fire of other catastrophic event'. ' B. Dwelling ha's'become a azard and risk to human health or safety. C. Case by'case request approved by the Director of Public Health. The .applicant must comply with all of the following: (a) Septic system operating satisfactorily. (b) Potable water supply meets bacteriological standards. (c) .Square footage of replacement essentially the same as existing structure. (d) Footprint of replacement essentially same as existing structure. (e) Same number of bedrooms as existing. Note: Definition of what constitutes a bedroom will be.made by department staff using same criteria in House Addition. Guidelines. (f) Approval by local town building and zoning laws. Note: Any increase. in square footage of dwelling or increase in number of bedrooms requires formal submission of plans from licensed Engineer or Architect meeting present code requirements. BRF /]P August 1995 Revised July 1996 houseadd i o. V, SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health July 26, 2006 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster; New York 10509 Victor & Christine Garcia 2 Brandon Road Patterson, NY 10563 Dear Mr. & Mrs. Garcia: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re:. Addition A- 219 -06 Incomplete Garcia- 2 Brandon Road (T) Patterson, TM # 25.49 -1 -20 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. Plans submitted to this Department for review have been returned for the following reasons: 1. 2. 3 I.......- .. _ , A 67 Proposed floor plans need to show the tax map number. Existing floor plans need to be noted as existing and show the owner's name, address and tax map number. If a basement -does not existing, this needs to be noted on the existing conditions plan. If a basement does exist; it needs to be included with the existing and proposed plans (drawn to scale showing all rooms and noting their use). The--property survey needs to, show the owner's septic. system location to the best of your knowledge. All wells and septic systems within 200 feet from the property line must be shown. It appears the survey shows a house footprint different from the assumed existing conditions plans and shows no garage. Please submit additional information in order to clarify. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. GDR:mcb Sincerely, An Gene D. Reed Senior Engineering Aide 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 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early lnterventioniPreschool(845)278 -6014 Fax(845)278 -6648