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HomeMy WebLinkAbout2242DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.06 -1 -20 BOX 19 02242 J6 IT I �, I 02242 IT 6 � �, I 02242 SHERLITA AMLER, MD, MS, FAAP :._. _.:__.. _ .. Cammtsstoner•o•�1Y.ec�th LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Naomi Hample 325 West End Avenue Apt. l OA New York, NY 10023 Dear Ms. Hample: ROBERT J. BONDI - - . ,. • - •_...., ..., �,�... .�i�ot�nty Executive ..... . ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 May 30, 2007 Re: Addition - Approval- Hample A- 106 -07 No Increase in Number of Bedrooms 234 Lakeshore Road (PV) TM #41.6 -1 -20 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 the Department dated May 30, 2006. 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. Tfie area of the ex>stin sewa a dis oral "s "ste � - � "� g g p y m- aiid'>'ts-exp'ansidri aYe"a'�ust $e """ 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. 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 Town of Putnam Valley. If you have any questions, please contact me at your convenience. LCW:ens cc: BI(T),Putnam Valley Very truly. yours, Lawrence C. Werper Public Health Engineer 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 Intervention /Preschool (845) 278 -6014 Fax(845)278-6648 71 y 6 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner. of Health DEPARTMENT OF HEALTH Geneva Road, Brewster, New York 105.09 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director t ADDITION APPLICATION RESIDENTIAL ONLY STREET'2. 4 jjauESt l� c�_TOWN h jv�4"t,_y TAX MAP# I .�f� NAME y'ati I e�+y1JaJ_t' PHONE f S' S1 .' 002A PCHD# MAILING `3 9-5 I :5 T 10 A, a�.r`:�. � • � � A ©`L� ADDRESSa(-.-01_M r 5; EAVC z 'E SONJ S � C..11 �CCrPf liC T-0 9'P, DESCRIPTION OF ADDITION -j;L). vz ° 0r= AtyrT1&JAE_ LAyiI16 -- PIVVIVI S psiL6— Ito NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CE' R IFICATION 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, 10509, Phone: (845) 278 -6130. 1. ertified check or money order for $100.00. 2. ketches 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. V / 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. �! Copy of Certificate of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE COMMENTS Environmental Health (845) 278 -613 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 $HERWTA,AMLER,_MD; MS, FAAP- - Commissioner'of ileallh' ' , LORETTA MOLINARI, RN, MSN Associate Commissioner of Health. ROBERT J.: _BONDI CoiintyExecutive DEPARTMENT OF HEALTH - 1 Geneva Road, Brewster, New York 16509 Town Legal Bedroom Count Re: (Owner's Name) Tax Map #: �% _ [ _ .2--b Address: Z 3 4- L.Acs- Shia2lS f` , Town: PUT WA M' ✓A Li E!l Year Built: According to records maintained by the Town, the above noted dwelling, i compliance s i n comp ance with Town Code. is not in compliance with Town Code. The Legal Bedroom Count is: This information has been obtained from:' Certificate of Occu anc Y p Y Other: Building Inspector Da Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 - -. - - -- w.. V-L oquare lt!el; W, - _ - - Dimension of Building Depth ! a Stories . x 3,ff . x x of I find plot plan to.conform to the Zonis bjectnto furthere pproval Putnam Valley and hereby approve same, and compliance with-.the requyrements of asean State rule eornd the Sanitary Code of this Town; as well as Bureau a Department regulation of the Stater County9 Town9 thereof. Date .c6 ilding and oning Inspector Paid., Building Permit Sanitary Permit Occupano -v Inspection Made: 1 ... ... ..... 71. 87 Date j­- TOWN 0 F RU" TN 1LEY 1704 R 1266TT Diftnct F E M IT ' Plicatibn.N hbeeW, m'ld'e for Description Addition Location, of Premises—Street or' Road Lake Shore Drive Vj. SEC.-` BLOCK LOT— FRONTAGE ACRES (other ceicripti6n) or number of square feet `mit Work.,to start 66ft'-,:&'. Bathroom. 3'4 Depth Rear oaring Brook. Laki- SUl3.D.ly[S1PN..NAME SEID, SHELDOW& BARBARA TMI18-3-4 PERMIT 4 87-1704 3,y Lake Shore Dr. W. — RBL Addition 8/17/87 RENEWALS: ENEWALS: AS BUILT: FOUNDATION: WELL LOG: CERTIFICATE OF OCCUPANCY, Addition Certificate ,-.of Occupancy, No .........8An! ... AppliCation" No ,87- 1794...... L Shore Drive W,,, TM#8-3-4- .ocLA6 ............................. aG ................................................... ............................................... Nybavin B itb-ara Se �j ....... .. of Z;!�..Lk. Shore Dr.-Putnam y.a. ... 1 ... I.e.. Y.2 ........... ............... g hiiii'o*'f'6"r'-e',"fil�e'a.'an�".,Ia'-" licationfor a building permit pursuant to,thi ' Zoning : Ordinance, Sanitary Code and -lhe-Lav Putnam Valley'.. t X , I , Laws' - effect in the Town of Pu P�fnam' Coun y, New, York, having paid. the. required &e therefor and the undersigned having by personal inspection ascertained that piovement of the proposed struc- ture,, i;,1w subsequently proceeded with the erection or, im 4VR40 In, . . I D. M--th-, comp a�ce. wi e requirements­ of the-law& ai- aforementioned'­ and • that • the - said - work' and; fikat6rigs;,� , et: every requirement of the, laws as aforementioned aid -that the premises have noi,' been . . fully. - completed and are ready for occupancy . pursuant to the provisions of law, Now, therefore,--". certificate of occupancy is hereby issued under the 'seal of the Town. of Putnam Valley this"� ...... 12 day of ..... qctober ....................... ........... 19.§�* Not valid, unless signed'in ink by a duly authorized agent TOWN 0 UTNAM VA YORK of and under the seal.• of the Town of Putnam Valley. By00 '; .... ...... ............................... $ Well TOTAL $147.00 7. Sanitary Permit Plumbing Permit CO B7 Well Permit, $ - ----------- TOTAL $ ZBA Approval A81r-,A APProval 0 po- 2QOWdon.@. Lu 'A M PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIIlB POC:4 - � y 1 vfv k 1- -, 17 70�— U-41— OFFICIAL USE ONLY SITE LOCATION 64o& TM# OWNER'S NAME P tJ is jvt om"Al r, 0® MAILING ADDRESS 4�,At*- 0.. r � PERSON INTERVIEWED PCHD Complaint #. Name & Relationship i.e., owner, tenant, etc. DATE TYPE FACILITY PROPOSED INSTALLER 1j, &/ - PHONE ADDRESS g c;Jrp,6 • Codd ' REGISTRATION# Proposal (inc9unde 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. d 4001 441 L c p. 5�e�d 1�2w W1 +'r' i Svt.�IJi✓+G:t . �t�Sti'- r1�`P 1Zi 1'�a�E -1 {!�1/�r2 �1���I•��.PI d1 a I, as owner, or orted agent f o er agree to the conditiO- •s statdd on this farm: SIGNATURE TITLE" DATE �J 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 corners). 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 Zbe rfo rmed in accordance with the above proposal and conditions. Proposal approved s Signature & Title : White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 9%E DATE J3 ftod Sheet of PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OI ENVIRONMENTAr, HEALTH -SERVICES'- " - � FIELD ACTIVITY. REPORT �I- NAMF: / �'`' /�` Tel, 91 AZRFCQ: 'Ole- T,T Street Town State Zip PERSON IN CHARGE Name and Title TYPE OF FACILITY: FINDINGS: Aid VS€ 4VAS7r- 1-0114 C:r ro qb/2 3j- PIP,E' TATQAF!`T(1T?- 14, ! TM . SignatutWnd Title REPORT RF- CFTWIT) RY. I acknowledge receipt of this report: SIGNATURE: 02/96 Title. Rev. N d CL N m.. N m ED N N Q 00 00 0 z X CE z AAA n ;1 a I P N41110d� 1 huscz 2 coj, e' e- �I of oC P1 QOCa2 � j' oa� W '3 �filUse. (Urt.� fl ro m :h T*WK ,tq-wq . II / wb:bf- Putnam Vkley Department of Health -..Division of, Sai#t&ti-on..; DESIGN DATA SHEET Location- SEPARATE SEWERAGE SYSTEM Block..... Located at LM4 Lot.... VV 31Z-5- Owner h cio,,, -4, -?,40�- er )V Afr/ Lot Area , Watershed— 42 g L L Bldg. Type SMirce of water supply: Occupancy. -QtT driven-dug well-spring-public .,, OF ROOMS:. Be�rooms ...... Future...... FIXTURES: Kitchen- dishwasher.... Garbage - 9 . de r ..... Bathrooms.7-. Automatic laundry ... Other .............................. SEWAGE FLOW: (200 gal./bedroom) ..... 6 .............................. (Increased capacity required for garbage grinder - 50%) TANK.CAPACITY;,6&V..gallons below flow line; depth air space../. .'TANK MATERIAL: .......... total depth...'- liquid depth.. width.:.., ...... length ............... partition............ SOIL TESTS: 1st .......... min.; 2d .........min.; 3d .... 4 ...... min. Soil to 5-foot depth..... ................... how known............... Tests made by ..................................... when................ ABSORPTION RATE allowed ........ S.p.s.f.p.d.; Checked by ... 4 ......... Gallons........ Rate........ Requires ..... sq.ft. bottom area,. trenches Provided by (describe absorption fk1d) ..... ............ P. ............................ distribution box prr,ovided USABLE AREA AVAILABLE ON PREMISES: .................................. DRAINAGE OF LAM (sh6w on sketch): natural .................... v ...... artificial ....... curtain rain..................... well- drained usable area MUST be 'pl-vided-before-approval,is issued,-. SKE IS REQUIRED.-and--must-show all'pertinent features; north point, property lines, existing structures, driveways, water or gas lines, sister courses, wells,, springs, dry wells or drains for roof or area drainage; DISTANCES BETWEEN SUCH FEATURES. COMPLETE PIXTs 11-7�:2 ADEQUATE DRAINAGE OF SEWAGE DISPOSAL AREA-all details of workable sewage system DATA SUBMITTED BY: _ -i �signature) (date) Ownefr(tl�r�,Builder( if corporation, give-title existing field Checked by: records (,); inspection( ) By -date a, of,-!Futoam Valley - Department of Health - Division of Sanitation DESIGN DATA SHEET SEPARATE SEWERAGE SYSTEM /-AV Watershed Q_ 1�, L Bldg. Type j�f water supply: Occupancy. driven-dug well-spring-public (Increased capacity required for garbage grinder - 50%) ''TANK CAPACITY- Kd-V..gallons below flow line; depth air space../.P.47. TANK MATERIAL: .......... total depth ... 1V1_4rT... liquid depth.. Tests made by ..... .............,.,,.,,.,.,,.,�.�..v�zoo.�^���~'�^,^�.~..''~ _ -_' � � � � a��.� d.� O�eu�od ��.., ,^ ... Gallons �� ^`^`^`^^ ^ ^ ^ l�^ `` .~.. Rato...^.... Requires ..... a ft bottom area,, trenches Provided by (describe absorption fiaLd) ..... O.A.-Y. ........... ° ....,..,.,..,^....^......... distribution box provided � USABLE AREA AVAILABLE ON PIEU0I8E8; ..^......,..... ,....^,',.,.^..... ' u~~~ | , � .' ., ��. artificial .. ,..,.. .^....... .. ^.... ~.^~ .��,,, .,' Well-drained usable area MUST be orDvidod before anprovaI is issued SKETCH.IS'.REQUIRED and must how all pertinent features; north po nt, ptoperty,lines, existing structures, driveways, water or gas lines, wa.�6r courses, wells, springs, dry wells or drains for roof or area di�l ain . age; DISTANCES BETWEEN SUCH FEATURES. COMPLETE PTA ' 17�3, 5C`.`R �DEQUATE DRAINAGE OF SEWAGE DISPOSAL AREA-all details of workable sewage system. DATA SUBMITTED BY: (signature) Fa—t _e7 biner(t,)�,Builder( ); if_corporation, give-title existing field 'Checked by: records inspection( ) B date VA g s i G r: 7 `a .q it �t .k s y is S, o r. b VC. :WC.a 1 e9.H91' . UC. CPC -192 PIZZELLA BROTHERS, INC.44&&�3 SC• L.E: �PPROVEO 8Y. O-TE : AC—SE0 - ' OAnw��vG n.vu OEA t :t 1 - Sq, 20 N Fence Park _ (Pe tm JOBO) 21' oak J Wk +� 14 lw _ 17' Ook - a a � obt Ti -,Ned Nby . ' 1 � — v NW B i i Oak 1B' M.N. _ t 6001 / 14 fTvr At a ' Jo' O k - - R onk Rock pf( P i 4� if'M i ..• /toand. Rock 4 j11 Wlo r Rock Qtiro/ . o 4.40 N 6 a t` -- 8' Bkch Lts — 12' Map /a. /� ` r p °� a wax 1 ton `¢ 11' Be /I' 0-k Be 12' Beech r _ m a 84 �Cv1 r_� -J _ 16' Beech O�plk - ➢/tone wb7k V ook Rx . ' -. 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