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HomeMy WebLinkAbout2325DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 41.10 -2 -42 BOX 20 J.,L,,,, Ar r1 6 Ir . ; , ` 02325 ,.�Y.. .. - n- ....... ....,. .. ._,- :r.. <x:.�.- ... :Va'xr ec- v.e _r- • . �. :rte SHERLITA AMLER, MD, MS, FAAP Commissioner of Health *F' ROBERT J. BONDI County Executive, LORETTA MOLINARI, RN, MSN ROBERT MORRIS, PE Associate Commissioner of Health Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count Re: '7 b tL" P L L D `-S (Owner's Name) Tax Map #: y/ D " 2 — Y Z.- Address: r T 6 `x Town: 9 Year Built: According.to records maintained by- the - Town, -the above noted dwelling - -- -- Is C/ in compliance with Town Code. Is not in compliance with Town Code. The Legal Bedroom Count is: This information has been obtained from: Certificate of Occupancy: Other: 4­55e5 5-0 ✓'5" ng Inspect r Date 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) 228 -2847 Fax (845) 228 -1580 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Joan Billows 53 Arbutus St. Putnam Valley,.NY 10579 Dear Ms. Billows: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health November 18, 2008 Re: Addition- A- 207 -08 No Increase in Number of Bedrooms. 53 Arbutus St. (T) Putnam Valley, T.M. # 41.10 -2 -42 I have received and reviewed the revised 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 November 18, 2008. 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 --- A1l-plu -rhh - fig - tunes- mus�be- updated `•with�vate-r= savitrg=devices-, ::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 (845) 278 -6130, ext. 2261. Sincerely, Gene D. Reed Senior Engineering Aide GDR:kly cc: BI, (T) Putnam Valley 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 PUTNAM COUNTY DEPARTMENT OF HEALTH N r' HO 'E PLANS APPROVED FOR BEDROOM COUNT 094A ° N El BEDRQOPJIS��� ° AL UBSEQUENT REVIS10WALTERATIONS TO THESE HOUSE PL S MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL r"ATI IRE & X U- co co 0 0 N N T Floor Qion sitIV - r- DATE ;ft Rm B R i i i J I fte"zbr i i bafflmfi QdG�C m IMP P TIAL a■r *2" POTENTIAL '' BFnR®nr.w EH�w 1rPrft.e sib ■m1ft IM , 30+a 4 Mle IAN ps lu—cm rrrr.a �� � IUe C Q cc 2 POTENTIAL '' BFnR®nr.w EH�w 1rPrft.e sib ■m1ft IM , 30+a 4 Mle IAN ps lu—cm rrrr.a �� � IUe C.�Y a 4 = - -pth Zo 8A TMENT HOUSE PLA PROVED F , ED OO Q $UNTO, HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY T 4 I' i /o - ;-Al D OOMS D �� �� I SI IRSF NT RR/ RItiN TO THESE HOUS I I° 2 9b AL SUBSE UE T REVISIONAALT R TIO S TO T eadr kdb14�� �0]a0w0f p PLC S MU 8E UBMITTE6TO HE CD H FO „ p Lmod°wddjdG7018n4D _ I I � I I I 00 amrmmsfmr Pm GmcWi WIN I I 4= - r (iNATU & TITLE ��' gI�9M8s°loNxj � r. C4I& mPAM e-NFirst Floor Plan _w =P-0° I' I woofilp I li I UTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY �o7�og F�, BED ROOMS I,/' A"//, /o - ;-Al I SI IRSF NT RR/ RItiN TO THESE HOUS CLANS MUS nE SUBMITTED TO THE PCD DH FOR APPROVAL ®®., SI NATURE & TITLE DA rdcrsa i � �WSW �. ®fkQaQ_m gI�9M8s°loNxj � r. fQi3W°9WM M t - - - --I L - - - -- tJ DID mft �i y rawft -v, ' 6b OVUM f04 8 f 1'4 SAP 9 y; 0pAm e -4 6 V L - -- _0 irv.v�rwoa agar f I i o® T 1R 49 Bf A Afto ago 1s�a�hfe1®�tet to a0wam th � I - -I )Okl 'C4 ') C)CL Y) 3; ) ) o vas 12 -? rly -D (AILAS ST To' J 10 2- ­q,;L Yj LOCATION MAP NTS IOT 56 ..1 ^p. 1,07 EWDECK ,rl SY NEW COVERED 4 p ENTRY o ,f '• ° �� ADDITION c LOT r yy , ` . cr m t HOUSE C o IOT , .,. T," O �t i t's° ZOP i _ Zt 1 � ti ~O I. LOCATION MAP NTS IOT 56 ..1 ^p. 1,07 EWDECK ,rl SY NEW COVERED 4 p ENTRY o ,f '• ° �� ADDITION c LOT r yy , ` . cr m t HOUSE C o IOT , .,. T," O �t ZOP _ Zt I. ;r //• '.�, '_:,, ���fHUri is ` � 1 I Mfnr r; —ovfr .•IOA frnme ------ SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Joan Billows 53 Arbutus St. Putnam Valley, NY 10579 Dear Ms. Billows: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health November 10, 2008 Re: Addition- A- 207 -08 No Increase in Number of Bedrooms 53 Arbutus St. (T) Putnam Valley, T.M. # 41.10 -2 -42 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 November 10, 2008. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at two without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area must be .. _ maintained. - "3. - ",U'plumbing fixtufes must be updat6d'wifh -wafer- saviiig'devices, i.e:, new low 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 (845) 278 -6130, ext. 2261. Sincerely, /� .�1 - 6a, ene D. Reed Senior Engineering Aide GDR:kly cc: BI, (T) Putnam Valley 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 4 SHERLLTAAMLER,.MD, MS, FAAP Commissioner of Health • LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Health ­-ROBERT J.. BONDI County Executive ROBERT MORRIS, PE Director of Environmental DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY STREET 6:5 &NL m St- TOWN P V., TAX MAP # NAME 1�C1Y1 TJi I I0w_$ PHONE PCHD # _� —� �l MAILING ADDRESS 53 Ar: hufm S4, Pufnd M V_s___110 4 �X S 10-S 7 1 DESCRIPTION OF ADDITION enUo,�ed ski r Wd l V'Ie v✓ be Danes NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OF 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. Pleaae suVinit-tliis'foriri and"the following -to Putnam County Health Dept.; 'l Geneva Rd -.;Brewster, NY-10509," Phone: (845) 278 -6130. 1 Certified Check or money order for $100.00. "Sketches of existing floor plan (drawn to scale, all living area including basement) Two sets of proposed floor plan (drawn to scale — with name, street and tax map #) * Non- /professional sketches are acceptable. A41 opy of survey showing well and septic locations to the best of your knowledge. Include date of installation if know. 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 Certification from Building Dept. 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 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 225 -2847 Fax (845) 225 -1580 A'!)'l A I J1* UP ij vz rp, r uA n SCALE 30 , DA TE- DEC'E�BER 2', 7,9 98 ified, as noted and limited below, only to MICHAEL A. & SUSAN P. PRINCE TIME" Y TITLE SERVICE-'::-), LTD. Title No. TCP--12582 MARINE MIDLAND MORTGAGE 6"ORPORA770N. ITS SUCCESSORS AND /OR ASSIGNS The surveyor's seal, signature and an y certification appearing hereon signify thot, to the best of his knowledge and belief, this survey was prepared in accordance with the minimum st'andards for land surveys os set forth ,,n the Code of Practice -adop.tec' by the New York State Assoc;cfion of Professional 'Land Survejwrs, Irc,. Certifications shah .ruo only to the person for whore? this survey was prepared, and or, his behalf, to the title cotzipany, lending institution and goveromeptal agency listed hereon; said certifications are not -'I'n- fended to to additionai -title comiponie.s, ;lending institutions, sub- sequent owriers or futore con,4roct vendees. Prep,ared by- Baxle-r P. 0. Br�x 14 7 Al&w "`ork 10547 FY)one­ 1.914i 62-1-8562 S N, r. !S ilic. No, 4,94J4 �r�ikh�- �z�'Y' T07AL AREA =-- 60"56", 1.j904 A,',­, '51 Only copies ies o,," the original oi, this surve,., f�,ictp surve_yors embossed sea.l.and hi,,�f. 6jonature sidered as valid true copies Underground ifnproverrients, strLiq'iure-, L,,th*J,11*�-, ony easements related thereto, are .noted. Unauthorized alteration or ad(-,Y itior! to land surveyors seal is a violat!aa of the New York ._'3tote Educafior, Law. TOXY OF PUTNAM V � , k1 mil) T iT Ai - OF PTIT/VA 11/1 V'. 1 iron r,.-,d found C 2' .A <. ?. S W f ` i -k tree J j guy ti cub.-e • -. � v tit, rsvi�P :y 40t, %,rte ^ + a G eU,Sf 3,•�;P �f nnS ttU._jep; ____...__ n icy •, „ 4 ✓lt J 7.>o.`h this P� �t ��W, �. The premises shown hereon being .lands identified as Lots 70 �c it : p ` on — and a portion of Lot ¢9 as shown: on a map entitled "SUBDl49SION .i OF ROARING BROOK LAKE, MAP -1. SECTION- -'C ": said maD filed 0 "CtC:'i '' itr?1?is a fd the Putnom,, County Clerk's Office on =Jule 28, 1945 as Mori ^10. Lo 1- 70 and portion of Lot hg were conveyed to tin.'icheal A. P_ Prince ;n Liber 1048, Poge 27 of deeds; Lot 71, lands formerlf. o` r. L ;eberrnon as per Liber 457, Page,, 38 ? has reputedly been conveyed of try the County of Putnam to Princ5. Ne deed of record canveying t said Loi-_ ?t to Prince was 'furnished at the time of this survey 1v 6_3-27 X"\x\"vIS .. W ,! M u \ V W h s p Ck vo- ft 1v 6_3-27 X"\x\"vIS .. W ,! M u \ V W h s p Ck vo- .g PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR ,` - / qC1 - os-- YES NO Internal Use Only 1 X �- IltG`t ❑ ❑ Repair Permit issued in last 5 years ❑ 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 .5 i3 , Zq jGIS 40 flu Vejl e TM # 1,1a - 2- OWNER'S NAME �i4r LLCJIci�� PHONE # MAILING ADDRESS .5�,, �c� s ,4Ly,• APPLICANT Name & Relationship (i. , ow tenant, contractor) DATE '/� 2 -�5� FACILITY TYPE v�� S PCHD COMPLAINT # PROPOSED INSTALLER ,� �Gw frG -Q- PHONE # Z.Z7 q,'u S' ADDRESS ( 7,oI t/,yl REGISTRATION /LICENSE # 172— 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. Dfferent location and proposed pump systems will require submittal of proposal from licensed professional eigineer or registered architect. I,as owner, or reported agent of own r agree to the conditions stated on this form 9GNATURr. TITLE ko op sal approved with the 4110 winp conditions: i Procurement of any Town Permit, if applicable. i 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 i System repair to be performed in cordance with the above proposal and conditions fi sal Approved Proposal Denied spector's Signature & Title Date ,'OPIES: White (PCHD); Yello (Town BI); Pink (Installer), Orange (Applicant) 1C-RP 99ML lev. 8/05 DATE X01or Ilk � it ffI 14 n Jo PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOIL SEWAGE IDISPOSAL SYSTEM REP AIR �_ -6® -0 5' OFFICIAL USE ONLY SITE LOCATION Arbutus, Putnam valley TM# X11,1 U- JW04g- OWNER'S NAME joan Billows PHONE 845-528-2922 MAILING ADDRESS Arbutus, Putnam Valley, "NY 10579 PERSON INTERVIEWED PCHD Complaint # ame & Ke-lationshiD i.e., owner, tenant, etc. DATE TYPE FACILITY PROPOSED INSTALLER Pizzella Brothers, Inc. PHONE 914 - 739 -3405 ADDRESS 7 Dogwood Road, Cortlandt, NY 1 §KdSTRATION# 36 -04 vl 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. VWi -" O'dL 1,- as-owher, orxeported agen f o er agree to the conditions f ted on this form. SIGNATURE TITLE i DATE?S�I I l� Proposal approved with the following conditions: 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 ormed in accordance with the above proposal and conditions. Pro osal approved 14�l. Inspector's Signature & Title COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML DATE B F ELEMENTARY 246 7668 A-0 i.j kf 08/24/06 03:39pm P. 001 �,Z: � C O r Q vn AUG-24-2005 WED 14:35 TEL:845-278-7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. v * b LN IN AUG-24-2005 WED 14:35 TEL:845-278-7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. v * LOT 56 L0T 55 S L(j fi• S-50, i iy \ f: N. V SL-RVE, Y OF PROPERTY °°'-° PREPARED FOR MICHEAL A • PRINCE:.— LOT 69 LOT 53 r°°,q al.0 LOT S2 ' Dec yyn•r,0 3s0.;.9• T �5 �V� P. PRINCE 7O SUSAN PROPERTY St TUA TE IN LOT 7 TOTrX OF PUTNAM VALLEY =_ ° = �• x x ' r r COUNTY OF PUTNAM 'ST. TE OF NEW YORK I t a .S •'.'1 °09'00° 11' —SCALE.- 1" _ !t DA TE' DECEMBER 21, 1998 a a �1 lLOT S,f wj o � 0 0 �r ems, A � A 0 n } °o y r 1,6' Certified. as noted and limited below, only to: j0°� / (11{x, iI. popt UI �f• - MICHAEL A. & SUSAN P. PRINCE - •� / I B; 4 Y "wry 5U�'7jy �a - llyrt y ARE SERVICES LID. ( litle No. 7CP- 12582 ) _ • 00° E r f r ,Il rr•�` r / /�, j� °+ y MARINE MIDLANDMOR7GAGf CORPORA AON, ITS SUCCESSORS i �•5h �11�j'� {{1�yf -/�/ \� 610 AND /OR ASSIGNS \• y ti V -y • • I L, rI0 JAe surveyor's seal - signature and any cerflrcotion appearing hereon �� ° • o n e r' \ �'7ry 017, ' signity that, to the best or his knowledge and betiel, this survey was prepared in accordance with the minimum standards for land surveys L Y f ""O" °• ».O °', • . ' as set forth in the Code of Practice adopted by the New York State r °j"'• . °' Association of Professional Land Surveyors, Inc. / / � •"Oj °' 4•hy„ sow pQ +r. � � - Certircations shall Mn only to the person for whom this survey was F 567 S0. TOTAL AREA = 60,T. \� �•' prepared and on his behalf, to the title company, lending institution " •r`:; and governmental agency listed hereon: said cerflffcotions ore not in- ( 1.J904 ACRES ) fended to run to =671ionol title companies, lending institutions. sub- - sequent owners ur future contract vendees. Only copies of the original of this survey mop .narked with both this The premises shown hereon being /ands identified as Gate 70 & 7` Prepared by�� surveyors embossed seal and his signature in red ink shot! be rnn= /' + and o portion of Lot 69 05 shown on o mop entitled SU80MSION \ - s;dersd os valid true copies. • OF ROAR /NC BROOK LAKE. MAP -1. SECAON -C'; sold mop freed in Baxter Land. Surveying, P. C. / r ' / the Putnam Count clerk's Office on Ad 28, 1945 as Ma No. Job -C. Underground improvements, structures, utilities o' encroochmen fs, and Y X p P. 0. Box 147 any easements related thereld are not shown hereon unless otherwise Mahopac, New Yolk 10541 noted I Lot 70 and portion of Lot 69 were conveyed to Micheal A. & Susan P. i It Prince in Liber 1048. Page 27 of deeds,- Lot 71, lands formerly of Unauthorized alfeiation or addition to a survey mop Aeorhg o licensed t Lieberman as per L1Der 457, Page 387, has reputedly been conveyed land surveyor's seal is a violation of Section 7209, Sub - Division ? of , f Dy fAe County a/ Putnam fo Prince. No deed of record con veyn9 Phone: (914) 62f -8562 �R06�rE. SAXTR, RLSL the New York State Education Low. sod Lot 71 to Prince was furnished of the time of this survey. N.':S. L,[ No 49434 F!, No s•1_36� O O cli O C> LZ' -C LL- ,ccr co <D fl— C> cli lZ I -r-err �- 8q S) J� 8 } tl�,s rNs -toy c —�r `5 LI I r. Z7 t. is PROPOSED WESTELEVAT ION Scale: yommix-on B I LLOWS: ADDITION AND ALTERATION TO REWD 'WE DESIGN DEVELOPMENT %-15-07 SERGE YOUNG Arcditeal 79 East wam street Bwml, Now York 125M ES AR4229 f 1 O � { CD N O { -Deck 11 f ^ N I co i 41`71 v" Lvl- : 2�dY►a ( t -n a aom CF I 2 I vv P o O .� o _ - - 0rA I uvnoam :i I RON wal 4 ;, i F S EllM �— 3 1 ,.' I I 1 1 bed Yrtii I, e, 1 P Y 4j I M0 PROPOSED FIRST PLOOR PLAN I j. IN O W S a ADOr1 H AND ALTERAMOU TO RMDEAICE ��'� I ° S E w Y a u N o° n°o� o w )EVELOPMEW ° Arel�lgfol c o 0 --j - �. 76�rstY�9a�r8tee(� &NO%81OM t290i ;a I N ' X78 - �f T X U- 0 r` 0 0 N N O T r OROSED NORTH ELEVATION B1 L L O W S: ADDl*n0N AND ALTERATION TO RESIDENCE DESIGN DEVELOPMENT 1045-07 Y% 1C._ SERGE YOUNG }. Arohlteot iB EW WE" st eel Besom Nm Yak 12W 945.898A228 . PU TNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # )11—o I Located at (To r Village Subdivision name Subd. Lot # Tax Map �4% /�# Blocky Lot Date Subdivision Approved Renewal Revision Owner /Applicant Name Date of Previous Approval Mailing Address 00 -,Y oXWG,e r Zip Amount of Fee Enclosed A9-v -f !i'd's VWL—/tc Building Type Lot Area / No. of Bedrooms Design Flow GPD El Fill Section Only Depth 3. 0 Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of /J, gallon septic tank and Other Requirements: To be constructed by Water Supply• �G jD Address Public Supply From Address PiiV46 Supply,Drilleday I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. Signed: P.E. R.A. Date Address f'i GG, �; ✓�� ��'.� _ License #/ APPROVED FOR CONSTRUC'T'ION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Appr d'fbr discharge of domestic sanitary sewage only. �,� /�/ By: .� - Title: Date: 2 White copy - HD File; Yellow copy - Building Inspector; Pink copy --0-w`ner, Orange copy - Design P ofessio al Form CP -97 4 t Public Health Director .t OREi' x "ivlOS:iT ARi R.N.; M. .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) 228!- 6108 Fax (845) 278 - 6648 April 30, 2001 Dan Donahue, P. E. 120 Breckenridge Road Mahopac, NY 10541 Re: Addition - M. Prince Arbutus Road No increase in Number of Bedrooms (T) Putnam Valley TM #14.10 -2 -42 Dear Dan: - 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 April 30, 2001. The addition is approved with the following conditions: L. The total number of bedrooms must remain at four, 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. The SSTS must be expanded as shown on plans prepared by Dan Donahue_ and approved by this Department on April 30, 2001. If you have any questions, please contact me at your convenience. WH/JP cc: BI Very truly yo , William Hedges Sr. Public Health Sanitarian zalo r .2840 f N r . ' y R NOOK 1a4 x 1s ! PORCH `•� 1488 7086 ties 2810 7810 2840 4089 C r: y . 5 23 , r M ENTRY LIVING i 173x97 18'8x14'9 I Imo' mo ..... -- ....... FITJTFFI o � G.1 UP r I 4888 2840 0 i FAMILY t BATH LAUNDRY 1a2x7210 r r1x4'a r1x3'1 r � DINING DECK \ El e' 13'2x_14'11 14'6x15'11 v 2840 5040 2840 3044 3044 3044 3044 06 LIVING AREA nMAM co 4/ } 6?) � N NAPP N$ BEDROOIi Co-' FOR T.pL AM 7Z EDROolfS Tkol, PAW 10' Z'2 .j- ?.cam• ` T;�.. -- a _r.J ,..?., ._� a ~ '� .. f.' s M ..31st 1'. lZ/ l° z a, t.. i t LIVING AREA 1274 sq ft 2 7 .J� / =i P6i1v1ium coow �'La3:�1� LiL.i 1 ; ?L 31.�AL HOUSE PLk%,S APPRO= Fob BED ROOM COUNT ONLY; , FJROOMS k 9 a' D i April 19, 2001 DANIELS. DONAHUE, P.E. •... c /1vUC: A /11. AA�i3 .�eiV \3$1 V.9.:e8:.�.6� — .,. .. -' a,.... 120 Breckenridge Road Mahopac, N.Y. 10541 914- 628 -7576 � D Putnam County Department of Health Geneva Road Brewster N.Y. 10509 Att: Mr. Wm. Hedges RE: SSTS. Addition Property of Prince Arbutus Road- Putnam Valley, Dear Mr. Hedges: Enclosed herewith please find the following: 1. Form PC -1 2. SSTS application 3. Design data sheet 4. Letter of authorization 5. Fee in the amount of $100.00 6. Short. EAF :. .....:. . 7. Three copies of construction plans 9. Two sets of house plans. I: Daniel I Donahue, P.E. Site Sanitary • Environmental PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES :_,-.:..:,. �... �.. �:... �.,„ f...... rr.:. x. �:--..o..: x�. �_-. �` APPI: ICATIONFORAPPit�OVAL` 'OP`P�;AI+1S`F011t•���:.:, <: -,� :..- .......:. __:... � ..t.... A WASTEWATER TREATMENT SYSTEM 1. Name and address of applicant: jt2ile -e 2. Name of project: sj6yA,E rx-w&- r.aF s 3. Locatitgv: 4. Design Professional:&JAt O &L J. ZWY,44(1r 5. Address: 144 6. Drainage Basin: A 4 i, &q 7. Type of Project: ,� �� 17 _ Private/Residential Food Service Apartments Institutional Office Building Realty Subdivision Commercial Mobile Home Park Other (specify) 8. Is this project subject to State,Environmental Quality Review (SEQR)? Type Status (check one) ....................... ............................... Type I Exempt Type II Unlisted y 9. Is a Draft Environmental Impact Statement (DEIS) required?—.: ,4L 10. Has DEIS been completed and found acceptable by Lead Agency? ............... All .41 11. Name of Lead'Agency 12. Is this project in an area under the control of local planning, zoning, or other offi cials, ordina�ices? �::: ..........................:.:............:.... .............:.: ::.........:... s. _ 13. If so, have plans been submitted to such authorities? ........ ............................... N 0 14. Has preliminary approval been granted by such authorities? Date grinnted: _ 15. Type of Sewage Treatment System Discharge ................. _ surface water Ygroundwater 16. If surface water discharge, what is the stream class designation? .................... N //1 17. Waters index number (surface) ........................................... ............................... _A,M 18. Is project located near a public water supply system? ....... ............................... &4 19. If yes, name of water supply Distance to water supply 20. Is project site near a public sewage collection or treatment system? ................ /10 21. Name of sewage system Distance to sewage system 22. Date test holes observed 23. Name of Health Inspector 24. Project design flow (gallons per day) ............... 25. Is State Pollutant Discharge Elimination System ( SPDES) Permit required ?... �o 26. Has SPDES Application been submitted to local DEC office? ......................... NI& Form PC -97 2 27. Is any portion of this project located within a designated Town or State wetland? //o 28. Wetlands ID Number ....................... 29. Is Wetlands Permit required? ....................................... ............................ I......... Al y Has application been made to Town or Local DEC office? ............................... 30. Does project require a DEC Stream Disturbance Permit? .. ............................... 31. Is or was project site used for agricultural activity involving application of pesticides to orchards or other crops, solid or hazardous waste disposal, landfilling, sludge application or industrial activity? ............................ YesV) 32. Is project located within 1,000 feet of existing or abandoned landfill, hazardous waste site, salt stockpile, landfill, sludge disposal site or any other potentially known source of contamination? ............................... Yes(& DESCRIBE: 33. Is there a local master plan on file with the Town or Village? ......................... 34: Are community water and/or sewer- facilities planned to 'be developed within 15 years in or adjacent to protect site? ................................ ............................... A V 35. Are any sewage treatment areas in excess of 15% slope? . ............................... /116 36. Tax Map ID Number .......................... ............................... MaPZ16&L Block a Lot `�-•- 37. • Approved plans are to be returned to ..... Applicant _J Design Professional NOTE: All atians for review and approval of a new SSTS to be located within the NYC Watershed shall be sent &S' ent, land need not be sent in duplicate to the DEP, although the project may require DEP .. approvae S prior to final approval by the Department. Projects within the watershed may also require i&vieA and approval of other aspects of a project, such as stormwater plans or the creation of �impery aom, and the project applicant should obtain the appropriate forms Tor such activities from -DEP an "'it. these fortes to DEP for review and approval. If the app$ ions signed by a person other than the applicant shown in Item 1.,the application must be, accompanied by a Letter of Authorization (Form LA -97). Failure to comply with this provision may be grounds for the rejection of any submission. I hereby afrm, under penalty of perjury, that information provided on this form is true to the best of my knowledge and belief. False statenaents.:rnade herein are punishable as a Class A misdemeanor pursuant to Section 21P.45 of. the, Feral Law. SIGNATURES & OFFICIAL TITLES: R�/► c- °�� v� Mkiling Atli cess ..:.: :.:::..............:..........- _ ._........ _ _... -- . _ -.. PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION Of ENVIRONMENTAL HEALTH_ SERVICES, 71 DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Addressj Located at (Street) Tax Map/ t-& Block Lot (indicate nearest cross street) Mtmicipality_. fv At4 /j,. e Watershed SOIL PERCOLATION TEST DATA Date of Pre-soaking Date of Percolation Test _A?X/"e. NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurementsto be made from top of hole. Form DD-97 17 2 3 d- 7 17 4 5 4- J_: 2 %z 3 ;/Z- 2— 4 5 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e. s I min for 1-30 min/inch, s 2 min for 31-60 min/inch) All data to be submitted for review. 2. Depth measurementsto be made from top of hole. Form DD-97 1.51 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.01 5.5' 6.0' 6.51 7.0' 7.5' 8.0' 8.51 9.50 10.01 le- Indicate level at which groundwater is encountered AMA/0- Indicate level at which mottling is observed Indicate level to which water level rises after being encountered dze Deep hole observations made by: Date -�651-e'l Design Professional Name: �/V V, 4J Address: loX-7,1 9,.,- v ,� of � Signature Design Professional's Seal s.1; 7-ron t: L 0.49 OF NE TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES, DEPTH �UULM40. G.L. 0.5 —1 .6 Aj 614 1.0 1.51 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.01 5.5' 6.0' 6.51 7.0' 7.5' 8.0' 8.51 9.50 10.01 le- Indicate level at which groundwater is encountered AMA/0- Indicate level at which mottling is observed Indicate level to which water level rises after being encountered dze Deep hole observations made by: Date -�651-e'l Design Professional Name: �/V V, 4J Address: loX-7,1 9,.,- v ,� of � Signature Design Professional's Seal s.1; 7-ron t: L 0.49 OF NE !4.161(1187) —Text 12 PROJECT I.D. NUMBER 617.21 SEAR Appandlx C State Environmental Quatity_Ro. iew ­SHORT ENVIRONMENTAL ASSEBSMENT FORM V . For UNLISTED ACTIONS Only PART I— PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT !SPONSOR T. PROJEQT NAME 3. PROJECT LOCATION: �,,, Municipality `,1 �"�'_` `� �e ( County t-j_�)f 4. PRECISE LOCATION (Street address and.road Intersections, prominent landmarks, etc., or provide map) 6. IS PROPOSED ACTION: N a w ❑Expansion E] Modificationlalterstion 6. DESCRIBE PROJECT BRIEFLY: & -Q,u a 77e 7 is ou d) Fv- t 01 ,y 'e) i t ,f "4v01? #-Ai iv i /.1/'t, ; a41114 R !' VI-N t P9t 7. AMOUNT OF LANG AFFECTED: Initially & / _ acres Ultimately acres B. WILL PROFOSEED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Yes ❑ No It No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? JvReslcentia! G Industrial ❑ Commercial ❑ Agriculture ❑ PaWlPoresUOpen space Cl Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL STATE OR LOCAL)? r Yes ❑ No I! yes, list agency(a) and permluapprovata L �) f� . 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUD PERMIT OR APPROVAL? 13 yes No It yes, list agency name and permltlapproval 12. AS 'A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION? (] Yes Adho i CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Date: ADDlicanUsponsor name: Signature: It the action is In the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER 1 PART II— ENVIRONMENTAL ASSESSMENT (To be completed by Agency) A. DOES ACTION. EXCEED ANY TYPE I THRESHOLD IN 6 NYCRA, PART`llit.12? If yes, coordinate the review process and use the FULL EAF. ❑ Yes (DRo B. WiLL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.0. It No, a negative declaration may be superseded by another Involved agency. ❑ Yes , Ram C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WiTH THE FOLLOWING: (Answers may be handwritten, It legible) Ct. Existing sir quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal, potential for erosion, drainage or flooding 0ioblims ?..Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shetllish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: Ct. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly. NOW e CS. Growth, subsequent development, or related activities likely to be induced .py the proposed action? Explain briefly. 3 CD 144:s ? Lang if, short term, cumulative, or other effects not Identified In C1-CS? Explain briefly. :> tt;;ir� -•-i � �. c3 �� ttter i meets (including changes in use of either quantity or type of energy)? Explain briefly. D. IS THER "e, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? Yes Uib It Yes, explain briefly PART Ili — DETERMINATION OF'SiGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect. Identified above, determine whether It Is substantial, large, impoflant or otherwise significant. Each effect should be assessed In connection with Its (a) setting ().e. urban or rural); (b) probability of occurring; (c) duration; (d) Irreversibility; (e) geographic scope; and (Q magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse Impacts have been identified and adequately addressed. C1 Check this box If you have Identified one or more potentially large or'significant adverse impacts which MAY occur. Then procesdcdirectly to ;the FULL EAF and/or prepare a positide declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed action WILL NOT result in s'y,slgnifirant adverse environmental Impacts AND provide dn'attachments as- necessary, the reasons supporting this determination: .t Name of Lead Agency tint or yye name of Gspons a Officer in lea Agency Title of esponsi a Officer rxv- .- �.,. -, � :.. <. . .. ..... _ a•.:......, .�.,. , -:.. .. •,: . <..,.�..:_z•, _'...... ,�.vx ,., o >•- •or "s.,: .. :.aaa,: -.y= _.:. _-. ,,.,w .s•.. _:. .-...�.•s ,e,,.. .. r..4._ ignature of Responsible Officeflm Lee Agency Signature of Preparef Of differ"t from respons ible officer) Date PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES r r s': \<;: i1 [ +. -a r. r-3. +�':t �- rr u'.'[['. c�.xa_T.vtvc�[ -Y '.: r.'s:. -r -: y^^�<-- :�.^ -,w: T�.cw-.�_.. ...e n . ... >. s ra.fs 1s... +a a_[e. �.-. +1 -..L r .. .c_wN.+Tr:.[ -�I.e ... r_ .. �a � < >!— ..�1a.'s.r.l✓'cr.. � : a RE: Property of Located at LETTER OF AUTHORIZATION GP I ax Map # . 4d-7- - +2 Block Subdivision of Subdivision Lot # Gentlemen: Filed Map # Date Filed This letter is to authorize 'DAN tnL T Niq Hxr Pr. Lot a duly licensed Professional Engineer ✓ or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations'as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater tretment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam County Sanitary Code. :... . Countersigned:;� P.E., R.A., # Mailing Address l�%A' ,ec -,4 ,, .ri State% Zips Telephone:��' Very truly yours, Si ed: v4��1 (Owner of Property) Mailing Address: / ��L✓l �� State Telephone: Form LA -97 I a a Sheet of * PUTNAM COUNTY DEPARTMENT OF 1FIEALTII DI- VISION ;O, -FE W RONMEN =I'A -L HEATLH- SERVICES Ft� YOB FIELD ACTIVITY REPORT NAME* y TAI; Street A1;�, ��c Tow PERSON IN CHARGE State Zip Name and Title / ell TYPE OF FACILITY: FINDINGS'. 1 �i�2 u2�s� ✓-Y- -� ��� A?�p- Signature and Title RFPl1RT RFr-FT FT) RY• I acknowledge receipt of this report: SIGNATURE: 02/96 Title: D .,.. 7 - - - - - - - - - - - ---- \ 41 "t ► { O t 00 00 SOO Ic cli N. N- I lu j e0.03 57 15.00 51 lE w-67 OW o Sheet of PUTNAM COUNTY DEPARTMENT OF HEALTH .DIVISION OF,EIVyjRQI�10' E� I_,�— � - T.:��I.SFRYIG tjr YOB nT rn FIELD ACTIVITY REPORT Tel: Street Town ^� Stage , Zip PERSON IN CHARGE Name and Title TYPE OF FACILITY: FINDINGS:T�tsa 2.�s� ✓- _-�. °� �G�il�% ay ,- �Z'� /- 1 7 Zr' G r� GAL /f f �_.� �/ '� �"`� �` v%� -,�-•- ly (� � / Signature and Title REPORT RECEIVED .RY: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rev. SHERLITA AMLER, MD, MS, FAAP Commissioner of Health .._. LORETTA MO'LINARI,.RN MSN Associate Commissioner of Health Joan Billows 53 Arbutus Street Putnam Valley, NY 10579 Dear Ms. Billows: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive - ROBERT Director of Environmental Health November 16, 2007 Re: Addition — A- 171 -07 No Increase in Number of Bedrooms 53 Arbutus Street (T) Putnam Valley, T.M. # 41.10 -2 -42 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 November 15, 2007. 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 Duilding.Department to ensure{:.:: _ f setbacks and other current codes can be met. 5. 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 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 at (845) 278 -6130, ext. 2261. Sincerely, Gene D. Reed Senior Engineering Aide GDR:ens cc: BI (T) Putnam Valley 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 'IV /01 /4VVf IV.LO rhA V V O/ vv I �r i =Z= { I 1 � m z O 4 M 03 ®, ®, Q rn L L_ -_ -- -- --_ .., PUTNAM COUNTY DEPARTMENT OF HEALTH' HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY J BEDROOMS 4 -1-71,07 •CtA -:0-' q1 110 -2 —�2 ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL 07 SI ATURF & TITLE ramt 11/15/2007 14:42 FAX _. n-. ..vim .. �...+ s. a<-. wvmva.rs.�.- .-- ._c,_,..._....,�_. cn.a •.r ,r .i<, v _-_. u,.,. x-_�.. ... ..s �.- �,r.v. �n _..__...:III �< . �e.. � x.�. u.. .. s -c �:rc.�'-tv...- T• U t.! C .Z PC) ra 2 _ r-A SJGF- m ICJ QQZ/QQ2 I� ro+AOa+c� • 1�+Ip I MIYP. CF �II DECKABME I NEW GOONEY FaUMMKIM b . _.. ClM1MdPACQ • - - _ I I I PUTNAM COUNTY DEPARTMENT OF HEALTH LOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS A — 177 l — O .LL SUBSEQUENT REVISION ALT RATIONS 0 THESE HOUSE LANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL GNATURE & T!TI -E BILLOWS: ADDITION AND ALTERATION TO RESIDENCE 53 Arbutus Street Putnam Valley, New York 10579 REVISED BASEMENT /FOUNDATION PLAN U 0AIU0! Scale: Y=T-O" SERGE YOUNG grchltect I 79 East wluvW SbVDt Drawn By SY Beacon, New York 12506 848.838.4229 rAAwt� gyp® , T T �.O YPE — '=UMFMW , I C61O.VaMAC6 I la1ooMrAmT.". 4 1 I � I I � � m0/iW�Wll� II CRAWLAPPM GOrFmA�, NOW MUO R4QN i I NEW GOONEY FaUMMKIM b . _.. ClM1MdPACQ • - - _ I I I PUTNAM COUNTY DEPARTMENT OF HEALTH LOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS A — 177 l — O .LL SUBSEQUENT REVISION ALT RATIONS 0 THESE HOUSE LANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL GNATURE & T!TI -E BILLOWS: ADDITION AND ALTERATION TO RESIDENCE 53 Arbutus Street Putnam Valley, New York 10579 REVISED BASEMENT /FOUNDATION PLAN U 0AIU0! Scale: Y=T-O" SERGE YOUNG grchltect Date: 11.06.07 79 East wluvW SbVDt Drawn By SY Beacon, New York 12506 848.838.4229 F � i m I a � k m F Tit _ :.dLi k'ellw loui-s- *Atla§tar WORLD CLASS COPIERS ........ - -- -------- /V -1 0r 4 j'r� 1 -nom 0' A V9,16 !)";V r c. d IOur"d , •`!Cu, ✓ •S y 48.9' . . i Cb UnoA9e - L 0T 0 e � ac D L /7 FRAME V �. ^y� SNFD 4.9' well pit CO o Q Q � x x . pole � J 3tloh.l,t 0 iron rod foun \ d 1 t /O.Z'N.. U.5' w ' tree „ S. u O pole i�'ci�eN ti f I ' f♦♦ryry` tone 00 56, c p h U l f p o 5 i e m e n \`1\ s p h o I t SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health October 26, 2007 Joan Billows 53 Arbutus Street Putnam Valley, NY 10579 Dear Ms. Billows: DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Proposed Addition — A- 171 -07 53 Arbutus Street Putnam Valley, T.M. # 41.10 -2 -42 I have received and reviewed the plans .for the proposed addition at the above mentioned residence.- Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: 1. Per plans and survey provided, it appears the proposed addition and deck will encroach upon the existing septic tank. 2. All rooms on the proposed floor plan need to be labeled and dimensioned. (Your plans have been returned for our use ):W 3. Please provide two foil sets of proposed floor plans. If you have any questions, please contact me at your convenience. GDR: ens Sincerely, Gene D. Reed Sr. Environmental 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 Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648 Nov 01 07 01:52p BUILDING DEPT SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health 9145268806 p•2 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal edroom Count Re: BILLOWS Tax Map #: ' 41-10-2-42 Address: 53 Arbutus St. Town: Putnam Valley Year Built: 1950 ROBERT J. BONDI County Executive (Owner's Name) 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: -1 This information has been obtained from: Certificate of Occupancy: C-0-4-20-03-296 4 d d i t i n) Other: Building File, 11/1/07 -"Building Inspec or Date 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 Nov 01 07 01:53p BUILDING DEPT 9145268806 p,3 CERTIFICATE OF OCCUPANCY CERTIFICATE NO: 2003 -296 DATE: 10/3/2003 PER MT NO: 2003 -306 TAX MAP 0 : 00/41.10 -2 -42 LOCATION: 53 ARBUTUS ST ISSUED TO : PRINCE MICHAEL A & SUSAN P 53 ARBUTUS ST PUTNAM VALLEY NY 10579 This certificate covers the construction of: ADDITION /ALTERATION COVERT SCREEN PORCH TO LIVABLE SPACE (DINING ROOM) (182 SF) The applicant having heretofore filed an application for a building permit pursuant to the Town Code, Sanitary Code, the Uniform Building & Fire Code and the Laws in effect in the Town of Putnam Valley, Putnam County, NY, having paid the required fee therefor and the undersigned having by ` --- -personal'inspeofion ascertained'that.improvement of the proposed--structure - is in compliance with the requirements of the laws as aforementioned; that the said work and materials meet every requirement of the laws as aforementioned and that the premises have now been fully completed and are ready for occupancy pursuant to the provisions of law. Now, therefore, the Certificate of Occupancy is hereby issued under the seal of the Town of Putnam Valley. TOWN OF PUTNAM VALLEY, NY By s Code Enforcement Officer I SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI -County Executive DEPARTMENT 'OF HEALTH 1 Geneva Road, Brewster, New York 10509 gip.: IS ADDITION APPLICATION RESIDENTIAL ONLY j . STREET �9rbok,5 S�. TOWN I�cc%!a TAX MAP# �2.'�•. NAME ✓ �5� ,8 I /IO W5 PHONE g o� g o2 PCIiD# 1� MAILING ADDRESS 53 cSf' Pufn am * 11 -e y I y 10-S `7,q DESCRIPTION OF ADDITION eh C/OS PG, . p rlC�7 91 /Y 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 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 Dep_t:; -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 including basement) 3. 1�w�ts of- proposed, floor plan (drawn to scale — with name, street and tax map #) *Non - professional sketches are acceptable - 4. Copy of survey in 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 Healtb (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 Q b i 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 PUTNAM COUNTY DEPT. OF HEALTH 1 GENEVA ROAD BREWSTER, NY 10509 To Whom It May Concern: Re: seL Lo \nl C Residence ROBERT J. BONDI County Executive TAX MAP# TOWN &Tg"AfA V According to ecords maintained by the Town, the above noted dwelling, -IN COMPL IANCE WITU TOWN- CODE... IS NOT IN COMPLIANCE WITH TOWN CODE LEGAL BEDROOM COUNT IS N9 This information has been obtained from/ : CERTIFICATE OF OCCUPANCY: �ASS�SSnfZSoiZ OTHER: � Building Inspector Date CERTIFICATE OF OCCUPANCY Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 lm 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 FROM FAX NO. Jul. 12 2005 11:32AM P1 AIM Ieaa�m ®!9A'i rn ®MlAwwwr��wiwlN,,, w�bmp (mww�rrs ®orYew ®ws ®�srwm ®wrybtw� DATE; - 07; - 07112- / () F: 5 -,;?7g , i TO: ` 3 A OIANir: _ iea l ` ' �-- C-C U v-, Ste. _ F O Ljo r 11 ou P�O�iE: S�t� G f�� l TOTAL PAGES (MC]LVDING COVER PAGR) Tw O GENT ❑ FOR REVIEW ❑ PLEASE REPLY COMMENTS: 3663 LEE ROAD,. JEFFERSON 'VALLEY, NY 10535 TELEPHONE: 914- %2.022 FAX: 914-962 -0149 B"CK & WffiTE COPIEPCOUM COPMkSi IPPING 5Mv1UKb MAnAOX SERVICES *POSTAL SERVICES *FAX SENDING AND RECEIVING T11_ -12 -2005 TUE 11:28 TEL:845- 278-7921 NAME:PUTNRM COUNTY DEPARTMENT OF P. 1 1oseJ ' eVH�� p • //11,, I ��, •'Ifs � 1, - a ! + I l J i' \ W � �yy PUTNAIVI COUNTY DE ARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY, BEDROOMS ALL SUBSEQUENT REVISIONfALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCDOH. FOR APPROVAL f J C eI � L-P lg 5I ATURE TITLE DATE FROM FAX NO. J L JUL -12 -2005 TUE 11:30 TEL:845- 278 -7921 " Jul. 12 2005 11:34AM P4 V d NAME:PUTNAM COUNTY DEPARTMENT OF P. 4 FROM :PIZZELLA BROS FAX NO. Aug. 24 2005 09:28AM P1 Augtast 24, 2045 Putnam County Health Department Joseph Paravati Assistant Public Health Engineer. 1 Geneva Road Brewster, New York 1OS09 Fax: 845- 278 -7921 Re: Joan Billows — Septic tank replacement .35'Arbutus, Putnam Valley, NY Dear Joe, In response to your phone call this manning rega din the tank replacement at the Billows residence: There is not enough room to got a wwrete tuck in. In order to safely get a tank past�the house I would need to bring- in a lot -of fili'and build a raft.- This-Would ; ...., cost a lot of money that she does not have. R urding the adjacent wells. t do not have, this infomation because it is a tank replacement and does not involve the fields. Please contact Ms. Billows for this information. cc: loan Billows AUG -24 -2005 WED 10:03 TEL:845 -278 -7921. NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health July 19, 2005 Joan Billows 53 Arbutus Street Putnam Valley, NY 10579 Dear Ms. Billows: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive Re: Addition — Approval - Billows No Increase in Number of Bedrooms 53 Arbutus Street (T) Putnam Valley, T.M. #41.10 -2 -4 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 July 18, 2005. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at two without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area must be -maintained. ° "�'�"' "" "' " "3 ". "'Ail pluriibirig'fixtures must "be "updated with w�'tefsa`ving de "vices'(�e. nev`�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. 5. Town records indicate that the legal bedroom count is three. Another bedroom can be added without an increase or change in the SSTS, but an application must be submitted to this Department for review. 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 yours, oseph S. Paravati Assistant Public Health Engineer JSP: cw cc: Building Inspector, (T) Putnam Valley Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 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 iY 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 PUTNAM COUNTY DEPT. OF HEALTH 1 GENEVA ROAD BREWSTER, NY 10509 To Whom It May Concern: Re: 1_ L fin.' C Residence ROBERT J. BONDI County Executive TAX MAP# TOWN &TR-ArA ALA F— Y According to ecords maintained bythe Town, the above noted dwelling, - Il`; COM- PLIANCE VU- .T- H -TO'� .N-C. ..._ -- -�- -• - - -- -Ifs -- _ .._._ _.� ...� -------- - IS NOT IN COMPLIANCE WITH TOWN CODE LEGAL BEDROOM COUNT IS This information hds'been obtained from) : CERTIFICATE OF OCCUPANCY: �+ OTHER: Building Inspector Date CERTIFICATE OF OCCUPANCY Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Im 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 Department-of Health 1 Geneva Road Brewster, NY 10509 53 Arbutus Street Putnam Valley, NY 10579 Tax Map# 41.10 -2 -42 Dear Joseph Pavaroti: Enclosed are f loor plans and application which state the use of the new space afforded by the raised roof over the dining room is for a bedroom and bathroom. Previous application did not state use of space and I had problem with the zoning board. This should resolve the discrepancy between the Health Department Application and the Zoning Variance Application. Sincerely yours, f� Joan Billows BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH I Geneva Road Brewster, New York 10509 LORETTA Associate Public Health Director Director of Patient Services 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 5 � 74Ybt�t� � TOWNL" � -�I N/��i Jco-n 31 II c9u%�PHONE PCHM MAILING ADDRESS DESCRIPTION OF ADDITION ba Gh�-I \TLIBER OF EXISTING BEDROOMS__ `�__PR0 4ED Pr OF BEDROOM0, 1 �j .t1 (FROM CERT. OF OCCUPANCY OR "`- rol raft) 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. ked roo;it — v. Please submit this-form and 4.hefellowineto Putna n� 6unty-Halth Dept.,'4 Geneva lroid, rewster, 10509, Phone 278 -6130. Certified check or money order for $100.00. Sketches of existing floor plan (drawn to scale, all living area including basement) *Non= professional sketches are acceptable. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map f') *Non- professional sketches are acceptable. 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. Copy of Cert. Of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE Comments Feb98 BFhouseguidelines BRUCE R. FOLEY _ . Public Heat_ Director = :..:_u ...: . LO_ RETTA ; MOLWARF R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTNrENT. 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 (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: Re: � 3 Uq1w- Residence Tax Map f?- – 41 Town. 52� According o records maintained by the Town, the above noted dwelling IS - • IS NOT ,...- . in compliance with Town code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER Mouse, I v / W %A4 P&S (-A ,I A I Eli law", u Id. -Cor 1 lows YID Tai Li I O-a 2. 1�23� jig( � 0 0 1r it Pop BRUCE . R. FOLEY Public Health`-Direcloi DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services 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 ONL)l STREET Y�(.� �.TT TOWN X MAP# lo q3& os NAvIE _)(! � � I �� dt t) PHONE �� `� �' 1°2 CHD# MAILI\TG ADDRESS DESCRIPTION OF ADDITION ices �9 o ✓er' d�n1oe MBER OF EXISTING BEDROOMSPROPOSED # OF BEDROOMW ,rte 04 1i.f0 i (FROM CERT. OF OCCUPANCY OR rp-8 vY� CERTIFICATION FROM BUILDING INSPECTOR) 4 *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) Y� prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. k ed roo nL- Please submit this form and the following to Putnam County - Health Dept., 4 Geneva Road, Brewster, NY �aihYUO6�`' 10509, Phone 278 -6130. exc t 1. Certified check or money order for $100.00.. Q c_e� 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 BFhouseo idelines D� ac(G �- W � i ►e ewSi �" 15/0 0 k; r: i� C tC me* }- $� 11a�s y« ` Co„ F� " )5� A). q <, It Of � O le 0014 4 U jq' l r,t floo r a I) I o z C/o ,cvo� 9 NEW" 0 4? 25 I Z,t,CA F)oor f 5�0 r,,. lott pro fospd leps T. NIA 21 1. 16 —2 -412— 1� C- A,( +V,i `A air D'A aid It o,1 R „e/ )cb small : 4 ,r a,. O �Oh Cie 2-T ' 1 ool ' c . �M1+YnvnAn,nn,l.a...b.n..w.A...w r �i rt Roo Tb i 11 o L0$ T)CA rue) Inn CCJ ..... n' C) c) Y— CL Y-Isti T. 2. 1111 � .50no\� ICA 4 "IlAa5lj i M* ti 1..16 .-2-142 P GOT SO Zor 05 •�; OT. 5q 00 Ir• ' • GOT 53 . 714 ` �-� �„ n a . • LOT 5z �; 1 l I OT 4 41 St, "R EY OF PROPERTY -r° .�r°.• =r��: n 4� —".'— w r PREPARED FOR \ 0 1 I ', MICH.EAL A . PRINCE ; LOT 69 ''` � �.•. � `� � � � j SUSAN P. PRINCE' D a • �$� ' �."� o GOT `i . � PROPERTY SITUA TE IN � .1 °z LL TO T1TN ' OF P UTNAIIT VALLEY =r oa. x k GOT q> ° COUNTY OF PUTNAM ° S'TA TE OF NE 11" YORK S 1 1•0s'00' 1T t 11 SCALE 1' = 30' i fv ti v q ( DA TE: DECEMBER 21, 1998 n ° 1 ;J 1 1 F7111 # \ a a ... ° f. 41 Ab Certified, as noted and 7imifed below, only to: ' � �'!:I a� s 6! U• �: - MICHAEL A. & SUS V P. PRINCE •°�q0 - TIMELY TIRE SERVI •ES LID. (Tfle No. TCP -12582 - MARINE MIDLAND MORTGAGE CORPORATION, ITS SUCCESSORS 11vr'6 AND /OR ASSIGNS �1�� 4,rnal ,eenj The fy th)t. t seal, signature and any certi(rcoliel t this ing hereon �� 1 r p epoy d in to the best it th know /edge and belie!, this nd surtey su was eO sr r • \Jh',UU• prepared in accordance w ;fA the minimum standards for land surveys Or set forth in the Code of Practice adopted by the New York State Association of Professional Land Surtrmrs, Inc. \ +b. 01 ••0.,bi•Ja " ^.,.0 sr �\ Cerfircolions shall run oily to the person for whom this survey was • prepared, and on his 6efio /f, to the title company, lending institution TOTAL AREA = 60,567 SO. F'T. and gorommenlol ogencty listed hereon; said certifications ore not in �� •,,: -, (ended to run to addilignol title companies, lending institutions, sub- (1.3904 ACRES) \ sepuenf owners or fulum contract v es f ende. rawer, r.. L.I. 41 • u 1 Only copies of the original of this survey mop marked with both this \ Prepared by. � surveyors embossed seal and his signature in red ink shall be con - The Premises shown hereon ibeing lands ;den fired 'as Lots 70 & 71 / sidered as valid true copies. and o portion of Lot 69 os {shown on a map entitled 'SUBDIVISION Baxter Land Surveying, P.C. "", I Or ROARING BROOK LAKE, MAP -1, SECDON -C•;- said mop riled in \ j Al Underground Improvements, struclures, utilities a- encroochmeofs, and, the Putnam County Clerk's Office on .Ally 28, 1945 as Mop No. J08 -C. P. �. BOX 14i any easements related thereto are not shown hereon unless otherwise' Mahopac, New York 10541 noted of 70 and portion of Lot 69 were con.e7ed to.Micheo/ A• & Susan P. •'r vrince in Libel 1048• Page 27 of deeds; Lot 71, lands formerly of Unauthorized o/te/afion or addition to o sur,et, mop hearing a licensed - Lieberman as per Libor 457,1'Poye J87, has repu(edly been conveved 4� (( land surveyw•s seal s o violation of Section 7204 Sub - Division 2 of Qy the County of Putnam to Prince. No deed of record con` YM9 P•[Ione: (914) 621 -8562 Rosmr E. BAxlm F.LS the New York Stdte Educotion Low. sold Lot 71 to Prince was furnished of the time of this survey, } N•'S tic No 494J4 y It frr No 4't -Jt;l +jv F V 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 Town Legal Bedroom Count ROBERT J. BONDI County Executive Re: j3' k16L p S (Owner's Name) Tax Map #: �j I , 10 � '1 X Address: 133 Aj bd;,-4-,V. s 3+ Town: Rt.T 6Lvs -,. 10 & 79' Year Built: According to records maintained by the Town, the above noted dwelling, is M` in compliance with Town Code. is not in compliance with Town Code. - . The Legal Bedroom Count is: This information has been obtained from: Certificate of Occupancy: n Other: Sse-s -s ys uA j Building Inspector Date 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 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI . A J ( County Executive ,OBERT MORRIS, PE Directo &ofEnvironmental Health DEPARTMENT OF HEALTH' 1 Geneva Road, Brewster, New York 10509 f ADDITION APPLICATION RESIDENTIAL ONLY cpv) STREET S o 1 TOWN �c, Arn AX MAP#�� pia NAME aci h 'Dr I lO LZ S PHONE $4 6 -& A",;l­Ct aPCHD# , ` I ' Li 7 MAILING ADDRESS 53 i'QCiX fTF � vu� DESCRIPTION OF ADDITION �Pa9 /laSb,�rr 77 6-AB) NUMBER OF EXISTING BEDROOMS c� 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 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 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 Certification from Building Dept. 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 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 L. ao i ��o`�ir�l1 �vain- . C}7fd5fp jc)cLn $; liok9 S t. 9 A S1'' 10/31/2007 10:28 FAX 10/18/2007 13 :47 FAX 12004/007 v f Y dD A Li 1 rr+ %T �1 R w 10/31/2007 10:28 FAX ry /fs /YOU( 13:47 FAX Ia 005/007 is J ot 1G � V-1 q fq T 4n T". oR 2 J ot 1G � V-1 q fq T 4n T". oR 2 10/31/2007 10:28 FAX CFs 0 Q w J 'r 4 �C7 0 -- r [6007/007 10/31/2007 10:29 FAX rn C� 0 b M c h Z rm001/001 U-R,� &noL 5.3 ,46A t_ ,,1 Po Aca� (-)., 164 ->t.Y 'ro r7ry T 5(,• _ LOT �5 r r ,y`;: ? ;To n' LOT 54 LOT 53 / •\ , \ ?.'1(L LOT, s'I,—. e o, w 52 N. •+ ° l LO � 5 >T �' S� tiC�r, u u 'fSO.7.y -'_ 20 o 5 S7, R i'EY OF PROPERTY PREPARED, FOR 1VMICHEAL A. PRINCE o i LOT 69 ,." d•° rb �, o SUSAN P. PRINCE ��- ° W 9•I0F f� L��i ,o PROPERTY SITUA TE IN TO TrAT OF PUTNAM VALLEY m -� �«• LOT �> . CO UNT Y OF PUTNAM w = STA TE OF NEW YORK ° SCALE. I- = X G �%; ��eee&4 a�). \ 2 :5s' .en e1 0 o i t r�a1' w..as• . 1 1 ,.,ter NO N O A t�. DATE DECEMBER, 21, 1998 n n, 5 53 °1:i 'O(1" 1F'�'e r r� `f O zn Certified, as noted ;iad limited below, only to: FjO�7�'10 EI s ot�r, d} MICHAEL A. rY SUSAN P. PRINCE 118; y p` 0' -�i; 0 07. Sa - TIMELY 77TLE SERNCES, I.M. ( Ttle No. FCP- 12581) E 1 `� r e \7 yv - - MARINE MIDLAND MORTGAGE CORPORA 770N, ITS SUCCESSORS 56 00 AND /OR ASSIGNS - Ile .r V,rr9 ^err The sur e,)w's seal, signature and any certification appearing hereon /.9, - signify trial• to the best of his knowledge and belief. this survey was UU prepared in accordance with the minimum standards for land surreys as set forth in the Code of Practice adopted by the New York State Association of Professional Land Surveyors Inc. / \ ° .'e'• e. �mvn., „ \ / SxMr N, a.r a \ Certirrotions sholl ram only to the person for whom this surrey wos prepared. and on his. behalf, to the title company, lending institution TOTAL AREA = 60,567 SO. FT and governmental ar;ency listed hereon: said certifications ore not in- ( 1.3904 ACRES) \� tended to run to additional UMe companies, lending institutions sub- sequent owners or future contract vendees. Only copies of the original of this survey mop marked with both this rho premises shown hereon being fonds identified as Lots 70 & 71 surveyors embossed seal and his signature in red ink shot/ be con - Prepored by . t /• 1 - and o portion of Lot 69 as shown on a mop entitled SU80fN510N - f sidsred as valid true topics Or ROARING BROOK LAKE, MAP -1, SECTION- C' i said mop filed in Bailer Land sumeyin.g, P. C. 7 Underground improvements• structures, utilities o• encroachments. and. the Putnam County Clerk's Office on Jily 28, 7945 as Mop No. J06 -C. P. O. Box 147 l any easements related thereto, ore not shown hereon unless otherwise-, Mohopoc, New York 10541 noted '� Lot 70 and portion of Lot 69 were conveyed to Micheal A. dr Susan P. Prince in Liber 1048• Pogo 17 of deeds. • Lot 71, lands formerly of Unwthorired olle/o6on or addition to o survey mop hearing o licensed 1 Lieberman as per Liber 457, Page 387, has reputedly been conveyed r land surveyor's seal is o violation of Section 7208 Sub - Division 1 of by the County of Putnam to Prince. No deed of record conveymg _ Phone: (914) 621 -8.562 ' Ro6Rrr.. a4xim P.LS the New York State Education Low. sokt Lot 71 to Prince was furnished of the time of this survey. N.`S tic No 494J4 E rvr No cr -J62 JO£c,, }� la I�! v I• HIV S �- OS y i 1 1 f ' i 9 7 A"d yd 'b .4 Q iJ TOty 7M1ss "tv gnirJ �/N �- TOWN OF PUTNAM VALLEY OFFICE OF BUILDING & ZONING 265 Oseawana Lake Road Putnam Valley, NY 10579 AM, MENDED CERTIFICATE OF COMPLIANCE Certificate No: 2011 -97 Date of Issue: 6/10/2011 Permit No: 2007 -5.1.1 Tax Map No: 41.- 10 -2 -42 Location: 53 Atbutus_St Parcel Owner : - Billows Joan' 53 Arbutus St Pifnam Valley NY l'6579' 4 ;,.. A_ DDMON 1ST FL (280 SF), AND REAR DECK (201 SF):. TO REMAIN AS T ikkC —B DROOMS. a ED 1!0 14/13,. x rs 4 xF _..- .Thy applicant havmg heretofore i Code, the Uniform Building A Eii Putnam County, NY, having paid; ascertained that improvement off aforemenrtoned; that the said'. that the premises have now been'i Now, therefore, the Certificate of VALLEY. stion ihWdii g permit pursuant to the Town Code, Sanitary the.Y avvs m,ffect,in =the TOWN OF PUTNA1v1 VALLEY, %:therefor and th''e undersigned having by personal inspection structure is tn�compiiance antl the requirements of the laws as als me�t�every requirement of thelaws as aforementioned; and ted =and are:ready for'oceupancypursuant lathe - provisions of law. is hereby issued under the, seal of the TOWN OF PUTNAM TOWN"OF PUTNAM VALLEY BY z�A Code Enforcement Officer