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631- 589 -8100
30.18 -1 -55
BOX 19
02192
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L
M
02192
ALLEN BEALS, M.D., J.D.
Commissioner of Health
ROBERT MORRIS P.E.
August 14, 2013
■
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10.509
Phone # (845) 808 -1390 Fax # (845) 278 -7921
George Siegel
328 Lake Shore Road
Putnam Valley, NY 10579
Re: Addition — A- 092 7:13
No Increase in Number of Bedrooms
328 Lake Shore Road
(T) Putnam Valley, T.M. 30.18 -1 -55
Dear Mr. Siegel:
MARYELLEN ODELL
COW' 0 Executive
This Department has 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 14, 2013. 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. _.
3. All plumbing-fixtur. s must be updated with water saving devices, i.e.; new low flush `
toilets,'restrictors for shower heads and faucets, etc .. .
4. The approval is for the modifications only and does not validate any construction shown
as existing that has not obtained proper approvals from other agencies having
jurisdiction.
5. This approval is valid for two (2) years and expires on August 14, 2015.
Any permits or variances required under the jurisdiction of the Town of Putnam Valley are the
responsibility of the applicant.
If you have any questions, please contact me at (845) 808 -1390 ext. 43261.
Respectfully,
Gene D. Reed
Senior Engineering Aide
GDR:cw
cc: BI (T) Putnam Valley
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
o aEPA ...:
Y Internal Use Only PERMIT
Li Ad Repair Permit issued in last 5 years 0- Not in Watershed
❑ Repair within Boyd's Comers, W. Branch or Croton Falls Res. X Delegated
❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review
SITE LOCATION 3 ;Ll TOWN UWww, q TM # 210 - V% —`- W
OWNER'S NAME q... ��.�,�� - PHONE # S; ES 106.S0?Ao
MAILING ADDRESS � % DL,=cd '. -QC6.01-N.1, k�t)C:n4
APPLICANT
Flame & Relationship (i.e.,
DATE FACILITY TYPE PCHO COMPLAINT .#
PROPOSED INSTALLER PHONE #K ,D WD
ADDRESS QO 7�jm 0,kQ 2a" REGISTRATION /LICENSE # \ ®2a
Pro sal (Include a separate sketch locating the house, property lines, ail 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.
xl 2..- - C e 4,%. "Z, %e 4., -�, _ `0.s,., ? : - r J. .A � _0 \A L-
1, as owner,agree Side condi
SIGNAT
:A rUvkd
this form
TITLE
PH
DATE
Bastin ®eS ._
I; the Ic ins r, agr o comply with the conditions of this permit or Ylie rri repair
SIG TUR TITLE La DATE
Pro the $Ilrt�ll
following conditions:
9 . Procurement of any Town Permit, lt 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 Flame, Town and Tax Map number
b. Location of installed components tied to two fixed points
c. System description (e.g., 9250 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 ft design and there is no guarantee to the duration at which the
completed SSTS repair will function.
5. No completed work is to be bacictiged until authorization to do so has been obtained from the Department
Proposal Approved
.� L,-.4
Signature l Title
is in compliance with
COPIES: PCHD; Owner; Installer
PC -RP 99ML
on a craoW.U. ores` %#UVL , o
Proposal Denied ❑ l
Date
codes Yes
Rev. 2107
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SAKE
SURVEY OF PROPERTY
PREPARED, . FOR
ANTHONY_ Di SCENZA
LOT:. 362
SHOWN "ON
"THIRD MAP OF ROA RING BROOK . L AKE
S /.rW rE IN .. .
TDWN OF PUTNAM ' VALLEY
PUTNAM - cowry, Y, NEW YORK.
SCALE, /"x 50'
Said mop filed Sept. 9, 1946 os Mop N° 308 -G
4 James C. Edgett, the surveyor who mode
this map, do hereby certify that the survey
of the property shown hereon was completed.
Mop. /7 /972.
Note: A)l certifications hereon are valid for this
mop and copies thereof only' if said mop
or copies beor the impressed seol of the
surveyor whose signature appears hereon.
Unauthorized alteration or odditiontothis
mnn k n violation of Section 7209 (2) of
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70.00
. . SHORE
ROAD
AD
SAKE
SURVEY OF PROPERTY
PREPARED, . FOR
ANTHONY_ Di SCENZA
LOT:. 362
SHOWN "ON
"THIRD MAP OF ROA RING BROOK . L AKE
S /.rW rE IN .. .
TDWN OF PUTNAM ' VALLEY
PUTNAM - cowry, Y, NEW YORK.
SCALE, /"x 50'
Said mop filed Sept. 9, 1946 os Mop N° 308 -G
4 James C. Edgett, the surveyor who mode
this map, do hereby certify that the survey
of the property shown hereon was completed.
Mop. /7 /972.
Note: A)l certifications hereon are valid for this
mop and copies thereof only' if said mop
or copies beor the impressed seol of the
surveyor whose signature appears hereon.
Unauthorized alteration or odditiontothis
mnn k n violation of Section 7209 (2) of
]1
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
.,...".... -.... ..PROPOSALPOR.SE'�NA— GE— TREATH MT "SYSTiE a
IN
Internal Use
"a, Re
❑ Repair Permit issued in last 5 years 121�- 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 'J�� TOWN ems, V ojVu,% TM # 30 - t% - t -;S-
OWNER'S NAME �.�,� PHONE # 3ko
MAILING ADDRESS �'�_s �?•.� `�, �d 1
APPLICANT
Name & Relationship O.e.,
DATE FACILITY TYPE � PCHD COMPLAINT
PROPOSED INSTALLER PHONE # AWE WE
ADDRESS tQ0 t y REGISTRATION /LICENSE # VU
Proposal (include a separate sketch locating the house, properly lines, ail adjacent nails within 200
feet of repair and the iocation of existing and proposed systom)
NOTE: The Department may require submittal of proposal from licensed professional depending on the
nature and extent of the repair.
I, as owner,agree a condition stat on this form
SIGNATUR TITLE DATE
I; these c. in er, agr o comply with the conditions of this- permit for i e septic system rboir
SIG TU TITLE V DATE JS'. -,),-)N0
Pro with ft fbilowing 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 Tau 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 backfilled until authorization to do so has been obtained from the Department.
ncsarrnnn nn nnrta rt iennn m
UUV V ItiWYV/FYY VYO7/IS VVV La Y
Proposal Approved Proposal Denied
l ifC
Ins®ector's Si ®nature & Title Date Ex®ira 'on Date
is in compliance with applicable codes Yes ❑ No ❑
COPIES: PCHD; Owner; Installer
PC -RP 99ML Rev. 2/07
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D-BOX
A HOUSE TO TANK 29'
B= HOUSE TO TANK 15'
C# HOUSE TO D-BOX 42'8"
D= HOUSE TO D-BOX 30'8"
it
A!
NOT TO SCALE
LAKE
George Siegel
328 LakeShore Road
Putnam Valley NY 105797!,.
As-ouilt-drawing TM#30-18-:1x55
Pennit# R- 119 -10
All rneasurments are approximate
Septic Tank is approximately 145' from Lake
-egs of pipe and gravel,
NOT TO SCALE
PHONE (845) 635-2102
dL-
P L U M B I N G
NOT TO SCALE
MEMORY TRANSMISSION REPORT
_.,,.,.,._w,:...._ �..._�- _:�. - >- .•..may, -
Tz1,,ME
TEL NUMBER .8452787921
NAME ENVIRONMENTAL HEALTH
FILE NUMBER 394
DATE JUN -07 04:30PM
TO 86035043
DOCUMENT PAGES 002
START TIME JUN -07 04:30PM
END TIME JUN -07 04:31PM
SENT PAGES 002
STATUS OK
FILE NUMBER 394 * * SUCCESSFUL TX NOT ICE * �
PUTNAM COUNTY HEALTH DEPARTMENT
plVIS10N OF ENVIRONMENTAL HEALTH SERVICES
C3-PQSAaf— [F=OR SFWAQP— -rF(11 a'4'6lfilMN1r aSVSTF -Gift REP JS
U ESL Repair Pel'trfit Issued In last 5 years G}A�r— neOt to waiersneo
Rapalr...[thtn goya•s Comers. W. Brar—h a Croton Fauns Ras - Cfati �olagatod
(� Q Repair within 200 ft- of a wrat�urse or OEGriappoc wopand a Joint Fleview
SITE LOCATION sj��i 1�,.t�_ �.e -..a. ��Q TOW9V TAA QI
4OWNER'S NAME - co-„�� mar.... ���..a_�ssr�: PHONE 14; ,- fLC_'SC'�3�r�
MAILINf3 AOCIRESS
APPLICANT
Name 6 Relationship Cl—. r. tenem[ r
OATS C'.7 -Z ' - t0 FACILITY TYPE -� ��_ PCHO COMPLAI rr &
PHONE if �y 00 2
AOdF eSS. �O Z'1_. met, ` 5.� 'Q
PrOboSBI OWMI scpa a oaparr®to sftotcft fexatfelg tfle fta -uaa, property (1how, amn a glecont walls wfftfofn 2co
timcit o8 ropafr artce 2"a irace;atta'n e91 ax0st9nS awed pnop®9304:0 syatemn) .
NOTE= -rho Department may require submittal of proposal from licensed professional depending on the,
nature and extent of the repair.
7 -
�. �i�^ �.h
1, as own r,agree a condition stet �n this form
SIt3NATUR TITLE
Q�esvatl ®r)
1, the se o ins agr o oom ply with the conditions of this permit for the septic system repair
SIG TU TI rL.F -: la wr LIATE L1: .
Qilnataff®
1. Prvcureintartt of any Town Porrnit, If appllcBblo-
2. Submission elf afs built repair okotch by the septic system Insmilor within 30 days of the repetir. In dupllcata showing:
a. Owners fWAMM, Mite Street Name, Town and Tax %Amp numbe
b.
a 0=ation eaf Inetftllesd components tied to two fixed points
0. System desoriptlon (a.g_, 1250 gal. Concf+eto septic tank. etc.)
d. Installers' name geld phano number
3. Mystom repair to be partotty od in se oordance with the above proposal and Conditions
.4. -rho proposed SSTM repair is eonsiderod a bast fit design and there is no guarantee to the duration eft which the
completed SSTS repair will function.
S. No eompletepcl work is to be backfilleed unfit authorization to do so has been obtainod from the Oeparttnent.
Proposal ApprovEml
Proposal L7ean_ _g f�'1 � L ly //Q
COPIES: PCHt7; Owner; Installer
PC -RP 99ML Rev. 2/07
MEMORY TRANSMISSION REPORT
_ -: TIl•;. = -.;; JUNrOZ- 20.10;,; 04;;40PM_
TEL NUMBER 8452787921
NAME ENVIRONMENTAL HEALTH
FILE NUMBER
DATE
TO
DOCUMENT PAGES
START TIME
END TIME
SENT PAGES
STATUS
FILE NUMBER 395
395
JUN -07 04:38PM
86351173
002
JUN -07 04:38PM
JUN -07 04:40PM
002
OK
* ** SUCCESSFUL TX NOT ICE * **
PUTNAM COUNTY HEALTH DEPARTMENT O
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
OPOSAL. FQFR SEWAGE SYSTEM RN- ="M
- - — - - - - -- ! 1G7 -I T�
t-I Repair Pemllt ftsuoo in tovi 5 yoels J'a-. rVOt In Water9hQQ
O Repplr within Boyd`a Cornerm_ W. Branch a Croton F0115 Rea- 1 Delegated
SITE LOCATION 3zow (,caii \,,, � Q TOWN Qg Nj.,. V oaaSmaa>j TM p ` ScO •-
OWNER'S NAME Cs•P�±•rra_ `�- �$�_„p� PHONE 0 ��k.�". At;; SU Cr-a
MAILING ADDRESS
APPLICANT
Name g Relsa_ohip P_e., er. tohertt o
MATE tC� PACILITY TYPE fin_......Q.sO PCH6 COMyP..I'JS\INT p
......._ ......- ......._PROPOSEO INSTALLER/ _ ,( .I `ili..r....� PHONE 0 �-6�� e�c.OLXTCf
ADMRESS �O �^' \ '�Ci� ••Q La.cab_ 'yc= ' Vc�i�+ fr'25_C- �ISTRATlQ7N/1...IGENSE IpR �og�.�„-
RMpgool (Include a eeparata akoitah Ioeatlng ilia Mouse, pro party linen, all adjacent walla within 200
foot of rapatr and the location of existing and propoaad system)
NOTE: The Mapartment may require submittal of proposal from licensed professional depending on the
nature and axtant of the repair_
_C5
W. !•. rae aC 9
1, as own r,agree a condition stet Qn this form
SICiNATUR TITLE MATE s�'F' //J
(owna
1, the se 0
c in r, agr o c/^o�(mp�l�y w/ljth the conditions of this permit for the septic system repair
TITLE 36 &A .. MATE
1 . Procttre o
rnant f any To P ®
wn armit, if apptibie.
2. Submission cf as built repair sketch by the eaptic systom Installer within 30 days cf the repair. In duplloato showing:
n. C7wrlar^a name, Site Straot Noma, Town aria T M ax ap numoor
b_ LAoeaslon of Installed componaryls, tied to two fixed points
o. System dascrlptlon (a.g_. 1250 gal. C�orlcrato - tic tank aft -)
d. Installers` name and phone number
3. system ropair to ba parforrrier! In accordanca with pia above prc penal and oondltions
4. -T-ha proposed SSTS repair is conaidared a best ftt design end there in no g"orarnee to the duration at which the
comaleted SSTS repair will function_
S. No computed work is to I,ae backfillad until auV,+ rtzaticn to do ao has been obtalned from tho Oopartmant.
i• INT- aFt"AL US6 ONLY
Proposal Approved �� Proposal Ma�ni d
Inspector's Signature & Title oat® P,»cpira on Uato
Repair proposal Is in complianca %y to applicalwe cooes Yes O No O
COPIES: PCHO; C7wner: Installer
PC -RP 99MI.- Rev. ?Jo7
iN�
�46
o -N
6T
PC
or-"91,0.1 C6-v 7,'/e -De-c- SeP+;, mk
k
Ids ------- Xn
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Trenc.6 'W'A
peg,
--'�Jvi loo
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3t,
box, sys r.;
15
JIIN- 03-2010 09:41AM FROM - ENVIRONMENTAL HEALTH
8452787921 T -068 P.001 /002 F-316
PUTNAM COUNTY HEALTH DEPARTMENT CJ
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL- FOR.;SEWAGE TREATMENT SYSTEM REPAIR
PERMIT# K-
❑ Repair Permit issued in last 5 years Pte- Not in Watershed
❑ Repair within Boyd's Comers, w. Branch or Croton Fails Res. 4K Delegated
❑ Repair within 200 it. of a watercourse or PEG -marred wetland ❑ Joint Review
SITE LOCATION 31-06 (a��.�\w,w. kcmeQ TOWN QCky eo Q 1 TM #
OWNER'S NAME 2= k PHONE #X45:
MAILING ADDRESS �'`a� \.1.y,.�s 1�- c5d�'_ •Q �cv� `Q. \ofiZ%
APPLICANT N-W _ kzb�,e.!
Name & Relationship (i-e.,
DATE ,2 -'l -ko FACILITY TYPE _PCHDCOMPLANT #�-�
PROPOSED INSTALLER yV xIL - a"04 ���.. PHONE # ,,Wkk" tTO
ADDRESS OO --- \S7 Ala Gt�a- Vat�(REGISTRATION /LICENSE # \02a
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 system)
NOTE: The Department may require submittal of proposal from licensed professional depending on the
nature and extent of the repair.
1, as owner,agreeAe conditiontqO�n this form
TITLE _ DATE Z 'e//J
(owner) d`-,—
1, the se to ins er, agr o comply with the conditions of this permit for the septic system repair
SIG TU om TITLES v DATE "S'
Prod &pproy wim the 121lowinq 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- Owners 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 pedormed in accordance with ft 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 backrilled until authorization to do so has been obtained from the Department.
KrERNAL USE ONLY
Proposal Approved IT Proposal Denied ❑
Inspector's Signature & Title Date Expiration bate
Fte air proposal Is in compliance wttn a licabltr conies Yea O No Q
COPIES: PCHD; Owner; Installer
PC -RP 99ML Rev. 2/07
z
51
NOT TO SCALE
NOT TO SCALE
NOT TO SCALE
George Siegel
328 LakeShore Road
Putnam Valley NY 10579
TM# 30.18-1-55
We are replacing the line from the septic tank to the distribution box.
We do not know where it goes and are unable to locate it sionce it is crushed. f
We will start digging at the tank and follow the pipe.
We will repalce the distribution box if it needs to be repalced.
We furnish as built when I know where eveything is.
Job is scheduled for June 4, 2010.
The septic tnak is under the deck.
LAKE
e
G
All measurments are approximate
i
Septic Tank is approximately 145' from Lake
ALLEN BEALS, M.D., J.D.
Commissioner of Health
ROBERT MORRIS, P.E.,.M_ PH _
TYirector ofEiivironmenfal Health M
August 14, 2013
DEPARTMENT
George Siegel
328 Lake Shore Road
Putnam Valley, NY 10579
Dear Mr. Siegel:
MARYELLEN ODELL
County Executive
OF HEALTH
Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390 Fax # (845) 278 -7921
Re:
Addition - A- 092 -13
No Increase in Number of Bedrooms
328 Lake Shore. Road
(T) Putnam Valley, T.M. 30.18 -1 -55
This Department has 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 14, 2013. 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.
_..,._., _....� - - -J.- All plumbing. fixtures niast-be- updated -with=watvr-savirigdevices; s:e:; -liew-loW flush - _ - - _.._
toilets, restrictors for shower heads and faucets, etc .. .
4. The approval is for the modifications only and does not validate any construction shown
as existing that has not obtained proper approvals from other agencies having
jurisdiction.
This approval is valid for two (2) years and expires on August 14, 2015.
Any permits. or variances required under the jurisdiction of the Town of Putnam Valley are the
responsibility of the applicant.
If you have any questions, please contact me at (845) 808 -1390 ext. 43261.
Respectfully,
Gene D. Reed
Senior Engineering Aide
GDR:cw
cc: BI (T) Putnam Valley
8•�
ADDITION APPLICATION
RESIDENTIAL ONLY
i
�J
STREET 12 f LAt� r 4,o ac- 2.0 TOWN PL)T. ` Al l.-G t TAX MAP # 30 -1` -
NAME J t Qa&Q PHONE ?c45_-5729-5J&_3 PC1FID#
MAILING
ADDRESS
(DESCRIPTION OF
a4i' dos -?-S
ADDITION bC�;DaL --QW , Mr4 5 (1 rl aj e-, NQE A
NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS c2
(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,in_cluding.basement, to be
.
__ ._.... shown anddimen'toned and-use-of a elf rciom'specified):.- .(See'Sect on 3:c-ofBtxlletint'
HA -1)
3. 'l'vt-o sets of p� c:�lx�sed floor plans (dmww ii to scale with name, street and tax map 4 )
1` Noi2- professional sketelies are acceptable acid preferred, (Ste 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
s.
I
Town Legal Bedroom Count & Proposed Addition Status
Re: Acx�,Qac— S(tEC=C—(-- (Owner's Name)
Tax Map #
Address: '12F blcc— ;wee 2-D
Town: n, NY
V
Year Built:
According to records maintained by the Town, the above noted dwelling,
is in compliance with Town Code.
Is not in compliance with Town Code.
The Legal Bedroom Count is: —3
This information has been obtained from:
Certificate of Occupancy:
The plans for the proposed addition are considered:
New Construction
Addition to existing house only
Teardown and/or re-build allowed under Town Regulations
[3 3
i§u,ding Inspector Date L
6.
ROARING BROOK Lev�-
71/'x- �1N1 c���f MI �/ •-
patio
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26 "42'3U r- ,
LAKE SNORE RDAD
SURVEY OF PROPERTY
PREPARED FOR
ANTHONY Di SCENZA
BEING
nT 3 09
SHOWN ON
VIRD MAP OF ROARING BROOK LAKE
SITUATE IN
TOWN OF PUTNAM VALLEY
PUT-NAM COUNTY, NEW YORK
SCALE I"= 50'
Said map filed Sept. 9, 1946 os Map AIR JOB- 6
e surveyor who mode Nole: All certificotions hereon ore "kd for this
rlify that the survey I ; ; mop and copies thereof only if sold mop
hereon was compleMd ; or copies boor the Impressed seal of the
". surveyor whose signature appears hereon.
70SN l-
7ciliaS _
QLe
v
71/'x- �1N1 c���f MI �/ •-
patio
N
4
• oe�
�25G8, U - - • - '
� I
2�
I
m
II
E � 8 = ®- ozw *v � j
26 "42'3U r- ,
LAKE SNORE RDAD
SURVEY OF PROPERTY
PREPARED FOR
ANTHONY Di SCENZA
BEING
nT 3 09
SHOWN ON
VIRD MAP OF ROARING BROOK LAKE
SITUATE IN
TOWN OF PUTNAM VALLEY
PUT-NAM COUNTY, NEW YORK
SCALE I"= 50'
Said map filed Sept. 9, 1946 os Map AIR JOB- 6
e surveyor who mode Nole: All certificotions hereon ore "kd for this
rlify that the survey I ; ; mop and copies thereof only if sold mop
hereon was compleMd ; or copies boor the Impressed seal of the
". surveyor whose signature appears hereon.
70SN l-
7ciliaS _
t,44013
I � V
t,44013
.._ 195. TOWN OF PUTN
�' No.... 5"63
- •---- ._______.: / AM VALLEY Application .....................
APPLICATION FOR BUILDING PERMIT Zone District....144,............
Application is hereby made to, (alter ..........
� . .._.....Work to start... f ° N `- =..._. ........
Building_,_ .... .. ••.. "' ..2 .......... � - - - -- ......• - -•- ....................
cydm T,
Location of Premises -- Street or Road..•..----- • - -... -----.------•---••- •-------- --- --- --------- - -- --- --------
SEC........ ......... ...... BLOCK ...................... LOT..... ? ..... FRONTAGE .__717.e ...... Depth ... ;MA .......
ACRES other descrip io ) o number of square feet ....... S�s7^ y / ............................. 2??q e -----------------------------------------
--- .... .............. -
OWNER .._ r..._ .. . ._.ADDRESS !-------------------
............................. x(f .•- ...._........
Dimension of Building
Width Depth Stories
X X X
X X A
X X X
Type Foundation ....................................
Size & Use Each ........................... I .... ....
Room with Window Area ....................
Sewerage Type ....... ............. ..................
Size of Septic Tank ..............................
Lineal Ft. Drainage ..............................
Size of Dry Wells ... ...............................
d ... igi� ............. ------- r, * ....
Additional Information: --•-------------------
This application mus be accompanied by copy of surveyors map and complete plans, specification, and all information
required by Coning Ordinance. and Sanitary -Code when -req. uested_by:_irispsctot'
-----------------.------------..:-_-:-.-------------- - -------- ----- _ ..... .. ......... the applicant, do. hereby certify that the above statements
are true to my knowledge and belief.'
.._ ®-� - ovov
Fee....... ?.....• C-•--•--------------- •-- ..........----- ••- - -• - -- Signature of Applicant.." ° c
.... Igna .
-I _ - :: rI:r.,-rri -"rn ��tolE —R `SYECIF`I�+ D_........_......_.....
OR NOT_;__AS, VIELL AS THE SANITARY CODE,• AND ANY OTHER LAVA RULE OR
REGULATION AFFECTING ;AID STRUCTURE OR BUILDING.
Date_- Signed
CONST.
ROOFING
LAND
l y
Wood
Wood Shingle
Paved
2 Faintly
Steel
b. Shingle
in
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
rick
Attic Open
Garage
Piers
ttic FUnished
OTHER BLDGS.
EXT. WALLS
PORCHES
Barns
BASEMENT
Wood
X Front
Shacks
art
rick
X Side
Cottages
Brick Van.
X Rear
Bungalows
e nt Floor
g
X Encl.
Electric
ed
Shingle
Phone
Garage B. In.
omp.
Furnace
field Stone
Dimension of Building
Width Depth Stories
X X X
X X A
X X X
Type Foundation ....................................
Size & Use Each ........................... I .... ....
Room with Window Area ....................
Sewerage Type ....... ............. ..................
Size of Septic Tank ..............................
Lineal Ft. Drainage ..............................
Size of Dry Wells ... ...............................
d ... igi� ............. ------- r, * ....
Additional Information: --•-------------------
This application mus be accompanied by copy of surveyors map and complete plans, specification, and all information
required by Coning Ordinance. and Sanitary -Code when -req. uested_by:_irispsctot'
-----------------.------------..:-_-:-.-------------- - -------- ----- _ ..... .. ......... the applicant, do. hereby certify that the above statements
are true to my knowledge and belief.'
.._ ®-� - ovov
Fee....... ?.....• C-•--•--------------- •-- ..........----- ••- - -• - -- Signature of Applicant.." ° c
.... Igna .
-I _ - :: rI:r.,-rri -"rn ��tolE —R `SYECIF`I�+ D_........_......_.....
OR NOT_;__AS, VIELL AS THE SANITARY CODE,• AND ANY OTHER LAVA RULE OR
REGULATION AFFECTING ;AID STRUCTURE OR BUILDING.
Date_- Signed
4)
rn
co
d-
(0
v
CD
z
H
CO
J
a
cc
w
F-
CC
m
c_
n
D- BOX ---�
r
A=_ HOUSE TO TANK 29'
B= HOUSE TO TANK 15'
C- HOUSE TO D -BOX 42' 8"
D�-: HOUSE TO D-BOX 30'8"
i
r
F
MOT TO SCALE
LAKE
't
George Siegel
328 LakeShore Road.'
Putnam Valley NY 105TJ
As- ouilt- drawing TM#30- 18 =1-55
Permit #R-119-10
;i
'i
e
' -i
i
i
f
4
house —�
All measurments are approximate
-; Septic Tank is approximately 145' from Lake
t
.egs ;o# pipe and gravel.
i
i
PHONE (845) 635 -2102
i
P L it M B 1 M G
NOT TO SCALE
NOT TO SCALE
P UTNi A_yI COL N TY DEPARTMENT OF HEALTH
DIVISION OF EN- VIRON`MENTAL HEALTH SERVICES
DESIGN DATA SHEET = SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner:
Located at (street): _
Municipality:
Date of Pre - soaking:
Address:
TM R' Section: Block Lot
Watershed:-
SOIL PERCOLATION TEST DATA
Witnessed by:
Date of Percolation Test:
Hole No.
Run No.
Time
Start —
Stop
Elapse
Time
(min.)
Depth to
water from
ground
surface
(inches)
Start - Sto*
Water
level drop
in in
Percolation
Rate
min/inch
--
-
I Z
I
I•
I
1_
.3
I
I
I
1
1 4
I
I
I
I
�
I
i
I l
I
I
I 3
4
'
2
3 I
I
I
4 I
I
1
I
I 1
t
r l
z
1 3
4 I I I
1
s
Votes:
1. Tesrs to be repeated-at same depth until approximately equal percolation rates are
obtained at each percolation test hole. (i.e., < l min for t -30 min/inch, < Z min for .i 1-60 miniinchi.
.1 11 4-r.. .- L— .... ..a C7-- —... .. .....
: Jiabnu2F <irntin�i(d:GS.mJi't.�JTrw•'. •"v` * ��Yv. i__-_:- �a.. iYv' rtiNb2itivHkie�kti» N. sz�:: ti1' t.. ri.. Py: uS�ri: JatJbliY' �CEks�S16iM: +8.ie- t�.;Iv11W:2:udak'sx::liYn a?S :.W:Ua1i':.�iasniwr.«:c::taF.l, x_ e.: ux`- tney .ialRV'..Siatn4lGdNAV�wi.4iti isaitluN .V:kd.:sfsi�td;xiw.fiu:.i�yy
TEST PIT DATX° .
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE # HOLE # H 0 L E # H0LE : HOLE #
G. L.
0.5'
1.0'
ANA
2.0'
2.5
3.7
3.5'
4.0'
5.0' .
5...
6.5
7.0'
9.01
9.5'
10.0'
Indicate level at which groundwater is encountered /� 6
Indicate level at which mottling is observed
Indicate level to which water level rises after be" o encountered
Deep hole observations made by:4,11 Date D
DesiJn Processional Name:
Address:
S i Qnat u re :
Desin Professional = Seal
. . _ _ ... __., _......r..r.vvwa+�rww wwWwrr.wrrwvvw�ov.r a;..•.• . .... .........
r,!
/5191• • • • • • • • TOWN OF PUTNAM VALLEY Application No. QQ.. S.
.--� APPLICATION FOR BUILDING PERMIT: Zone District .TJ..,.....
Application is hereby mode to erect (alter) .................. _..........Work to start ............. .
Building .... i- "-4...--w ..............................
.
y_ _
Location of Premises — Street or Rood ...� .�'�"'�•-C._ .. ... .... ........:.. .
ZOSEC: . BLOCK- : . . -LOT`. 4 :4..FRONTAGE Depth :32Rear. .%.- D ACRES (other description) or number of square feet ....Zk .- / .... ................ I ..................
"n Sc G i(/.Av
.......................... . ^_..................,..........
OWNER . )0-f. ADDRESS .. 4z. a`.`/rC . ,� .....
Dimension of Building
d h G D�ejpyth 9' St
X 9C �r X
'; USE
X X X
X
Type foundation
Size U use each ................
Room with window area ..........
Sewerage type -71Y.
Size of septic tank
Lineal Ft. Drainage .. .......
Size of dry wells ...................
Additional information: ..........
This application must be accompanied by copy M surveyors map and complete plans, specification, and all information
required by Zonin Oiginance and S •tary Code when requested by inspector.
the applicant do hereby cV$;f thAt the above statements are
true to knowledge and belief. oll
. deaes
Fee . '0�e -o ...................... Signature of Applicant . .... .
. .0
Certificate of Occupancy Issued
CONRTRIIOTION I
ROOBIN6 �
LAND
1 FAMILY
.WOOD
I
WOOD SHINGLE
PAVED
2 FAMILY
STEEL
A$B. BIIINGLE
I
DIRT .
LOG CABIN
BRICK
TILE ,I
OILED
BUNGALOW
CONCRETE
METAL I
SWAMP
APARTMENT
STONE
I
BROOK
STORE
. BNDTNS. I
INTERIOR I
LAKE F.
STORE & APT.
STONE
ROOM$ I
DAMS
STORE & OFFICE
CONCRETE i
APT. ROOMS I
$W. POOLS
OFFICE
/—BLOCKS---
APT. I
TEN. COURT S '
GAS STATION
BRICK
I
IATTIC OPEN
GARAGE
PIERS
FINISHEDI
OTHER BLDOS.
EXT. WALLS
I PORCHES
BARNS
BASEMENT
WOOD
% FRONT I
31HACKS
PART
BRICE
R SIDE
I
COTTAGES
'
FULL'
BRICK VAN.
X REAR
If
BUNGALOWS
CEMENT FLOOR
LOG
X ENCL. -
I
ELECTRIC
FINISHED
SHINGLE
Ij
PHONE
GARAGE B. IN.
COMP.
I
FURNACE
FIELD STONE
X X X
X
Type foundation
Size U use each ................
Room with window area ..........
Sewerage type -71Y.
Size of septic tank
Lineal Ft. Drainage .. .......
Size of dry wells ...................
Additional information: ..........
This application must be accompanied by copy M surveyors map and complete plans, specification, and all information
required by Zonin Oiginance and S •tary Code when requested by inspector.
the applicant do hereby cV$;f thAt the above statements are
true to knowledge and belief. oll
. deaes
Fee . '0�e -o ...................... Signature of Applicant . .... .
. .0
Certificate of Occupancy Issued
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WILLIAM ALEXAA re 4-1,v OF P41 -rmv1 Ow i E y
8 GARDEN STREET
L BREWSTER, N. Y;
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RORRIW4 9'eooe Iqe-r
WILLIAM ALEXAA re 4-1,v OF P41 -rmv1 Ow i E y
8 GARDEN STREET
L BREWSTER, N. Y;
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RORRIW4 9'eooe Iqe-r
WILLIAM ALEXAA re 4-1,v OF P41 -rmv1 Ow i E y
8 GARDEN STREET
L BREWSTER, N. Y;