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Home My WebLink About2239DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.06 -1 -12 BOX 19 I I I ., hi OrIr , 11, �, r .A . Li T' 02239 ix tt AL SYTEIVJ;TREPAIR t' 'y :ONLY, v;j VS .:.." . 1*.-A;.1-'-.-".-.4-'1:,V E OP �1 4"M OFFICIAL tr :tp- -tv ik NZ, - .v 4. 't op 2" SITE LOCATION' I I t 'sue; h-1 �ev Pis PHONE , 528-8423 OWNER'S NAIA'* "Mr","ji-a" MAILING ADDRESS PERSON INTERVIEWED'Mr'.` ' ?CHD.CoMplaint # ameX Retapo 'M ki e ownerlenan�,.etc iv Y ` Jew --6 28-45K PROPOSED 1NSTATLFR-*jfi66j"" THONE--� REGISTRATION#' 13-01 ADDRESS 485`Kihhi6ut: Hill `-Rd Proposal (include 'sketch locating adj*:a"'c'ent,.'wells).-,.-:-... tp, type"as'.'on' gi system must e m same T14- NOTE: Repair: b im6166atiba and"of same aal seWage'disposal Diffdre ocation aI may require :.Sub rmj&,of-- architect. pro om*, I form -1, -Aug - r", o.7e� agree tobe c6d s,,stated on this SIGN TITLE DA Prop Sal approved N�dfh conditi ons: f 1. Procuremefit'of any T,6w'n permit,-.,,j applicable.. 4", P. 4-1 0 a. Map eeit un6-," S 1.6ii4fid Tax b. S number c Location of installed components. tied to two fixdd points' .,n se corners d. System descriptibn'(e.j*., gal. Concrete septic tank; three� pr- X Gdeep 6iffiber. e. Installers' e and the Abov6.�3. -Syst'em'-repair 'to'be'pe'rfoinied idac6brdahce with conditions. �.P ropos-,al a' pprpvle, Inspector's Signature & Title C 41 6 1 ition SIGNATURE built wn name' it S :0 I (T - BD;f COPIES :� Miti�'(P CHID); Yel ow ,o� �v, PC -RP qq&jL. MAHCrrAC SANITATION SEPTIC, EPTIC, INC. Septic Tank S'ervice 217 Kennicut Hill Road MAHOPAC, NEW YORK 10541 628-4526 Joseph A. Mantovi I� 51 ID&W#LK gr I-D 6p.44 O I-TIP" 9, -10 &-o io C *0 7,0 6m- 0��® 7'c 4 'OP PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OFFICIAL USE ONLY SITE LOCATION 270 Lake Shore Dr. West, Put- Valle e TM# 41.6 -1 -12 OWNER'S NAME Mr R -And" >~ i al ds; PHONE 528 -8423 MAILING ADDRESS PERSON INTERVIEWED. Mr. Fields PCHD Complaint # Name & Relationstup i.e., owner, tenant, etc. DATE April a, 2002 TYPE FACILITY Private Dwelling PROPOSED INSTALLER, Mahopac Sanitation sett i c, Inc- PHONE ADDRESS 485 Kennicut Hill Rd., Mahonac NY REGISTRATION# 628 -4526 13 -01 0 o (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. . Renlace steel t' -ank with naw Plactie Tank_ Same location I, as owner,. orted agent. oJ owner agree-to, the 'con s , ated on taus form: - • _. _ ..._... _� �.._......... -- �. 2ees2_ SIGNATURE � TITLE DATE Y0 2 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 DA COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML )(ERLITA AMLER, MD, MS, FAAP . Commissioner of Health ' LORETTA MOLINARI, RN, MSN ROBERT J: BONDI County Executive ROBERT MORRIS, PE D' E IHalh .. fissoctate Commrssroner of Health . - . trector of rivrronmenta e t : DEPARTMENT OF HEALTH - 1 Geneva Road: Brewster, New York 10509 - ADDITION APPLICATION RESIDENTL4.L ONLY rot - STREET -a 70.1- AKES;IloR. RD TOWN v- MVAU TX MAP #. -2- NAME AIZP uQ l2�cv iT� Px ®NE ,fib I -gad 9 'CIIIII# MAILING.' ADDRESS. a-70 L, AKC 110 D vvr : A);% 10,5'N DESCRIPTION OF - G 0A)V, TV_ 0 Al ih�'A7297b ADDITION. POPW 4.727 t/LL_ L_I VIA) r_ S�/�� t' �Z��noa�� /n17ts21 oiL6 . NUMBER OF EXISTING BEDROOMS-__3 .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 permits prepared by :a-Professional Engineer-or Registered Architect in accordance with applicable sections of the- Putnam.Coonty Sanitary Code. .'Please - submit this form and the following to Putnam County Health -Dept., 1 Geneva Rd, Brewster, NY -10509, Phone: (845) 278 -6130: Certified check or money order. for $100.00. - �I'2: Sketches of existing floor plan (drawn to scale, al _livin area. including baserngnt, to be J shown and dimensioned - and use of each room' specified). (See- - Section 3.c of Bulletin' HA -1) k/3. Two sets of proposed floor plans (drawn to scale --with name, street, and tax snap #) - 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. X15. .Copy of Certificate of Occupancy from the Tow-nor Certification from the Building Department with legal bedroom count of dwelling: OFFICE USE COMMENTS " 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 -2847 Fax (845) 225 =1580 REBECCA WITTENBERG, RN, BSN Public Health Director . . ROBERTWORRIS;'PE' .. _ ....w <...o.....r Director of Environmental Health December 19, 2011 DEPARTMENT OF . HEALTH 1 Geneva Road, Brewster, 'New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 77921 Timothy Harper & Nancy Bobrowitz 270 Lake Shore Road Putnam Valley, NY ,10579 MARYELLEN ODELL County Executive Re: Addition- A- 158 -11 No Increase in Number of Bedrooms 270 Lake Shore Road (T) Putnam Valley; T.M. 41.6 -1 -12 Dear Mr. Harper & Ms. Bobrowitz: 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 19, 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. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush 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 approvalis 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 Town of Putnam Valley. If you have any questions, please contact me at (845) 808 -1390, ext. 43261. Sincerely, Genie D. Reed Senior Engineering Aide GDR:cw cc: BI, (T) Putnam Valley PUT1^dAM COUNTY DEPARTINIENT OF HEALTH HOUSE PLANES APPROVED FOR BEDROOM COUNT ONLY BEDROOMS A o- ALL SUBSEQUENT REVISIONiALTERATIONS. TGTHESE HOUSE • j i SHERLITA•AMLER, MD1 MSj FAAP Commissioner. of Health I.ORETTA MOLINARI, RN, MSN' Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental'Health DEPARTMENT OF.HEALTH l Geneva Road. Brewster, New York 105.09. Town Legal Bedroom Count & Proposed Addition Status Re:' xarper /Bobrowitz . (Owner's Name) Tax Map # 41.6-1-12 Address: 270 Lake Shore Rd. Putnam Valley Town: Year Built:. .1953 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:.... . ,.;.._..., Certificate of '.Occupancy: Other: Building Dept—Plan The plans for the proposed addition are considered: New Construction xx Addition to existing house -only Teardown and /or re -build allowed underTown Regulations 12/5/11 Inspector. , Johri H. LancTl Date. 6 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 -2847 Fax (845) 225 -1580 v . MZP��,% R.1 r 5 M4 f RIM% l:-A iK --Q D IN, NOW ... R-K vt Of -%v -03711A . 29 1- 0 - v M"M Uv�l On N16 y tA: t 4 14 JP fA: 27:7 M. .4?z ......... � � SEC. . . . . '�. . . .. . BL�� . . . . ', . ' '.' L�T . ��,� �r. . . .F��mT/\GE .�r`' ..' . .... Rear. 6.9:��` ^ . «��"» ACRES (other k�n} or '�� .''..'.......'''.'....,,^............. . --__,' '�~' , .. . '' ' ' ' ' .............. ' 'v—' ' ' ' OWNER. . _' — .. _ — v` -- . . . ' . ' .. . ' . , , ' . , . . ^ . . ^ . . . ^ . , . ^ . . . . w« Dimension of Building Vidt Stories Depth 04- �� x x m x Type foundation�&4 ~ �/._r- Room with Sewerage type '(9. Size of septic ton Lineal I Ft. Drainogeliw. GA H B. IN COMP. FURNACE Additional informatiom: ... FTELD STONE AG -This application mu7i;e accompanied by copy of surveyorms �m and -complete plans, specification, and all Information required j g(e%i�inanc%'an`!t)Sonitary Code when requested by inspector. true to aw kn6viedaepand 'lief. Z USE CONqTRUCT]ION ROOFING 1, LAND PI FAMILY WOOD' WOOD SHINGLE PAV i JWJJ 2 FAMILY STEEL _;ASB. SHINGLE ILOG CABIN BRICK TILE OILED BUNGALOW CONCRETE METAL SWAMP APARTMENT STONE BROOK STORE FNDtNS. INTERIOR LAKE* F. STORE & APT. OTONE ROOKS DAMS STORE & OFFICE CONCRETE APT.ROOMS SW. POOLS OFFICE BLOCK$, T. TEN. COURTS GAS -STATION BRICK ATTIC OPEN GARAGE PIERS FIN HEPA B DOS. OTHER. V "EXT. WALLS POIRCHEir, BARNS' PART BRICk 4vx- SIDE COTTAGES FULL BRICK VAN. X REAR BUNGALOWS CEMENT FLOOR LOG X ENCL. ELECTRIC FINISHED SHINGLE PHONE Vidt Stories Depth 04- �� x x m x Type foundation�&4 ~ �/._r- Room with Sewerage type '(9. Size of septic ton Lineal I Ft. Drainogeliw. GA H B. IN COMP. FURNACE Additional informatiom: ... FTELD STONE AG -This application mu7i;e accompanied by copy of surveyorms �m and -complete plans, specification, and all Information required j g(e%i�inanc%'an`!t)Sonitary Code when requested by inspector. true to aw kn6viedaepand 'lief.