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HomeMy WebLinkAbout2361DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.14 -1 -40 BOX 20 02361 f T y; Li '� r or 02361 BRUCE Public Health Director William Duncan 75 Pudding St. Putnam Valley,NY 10579 Dear Mr. Duncan: __LOR_ETTA. _MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT, OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 April 7, 1999 Re: Addition - Duncan - Pudding ST. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 41.14 -1 -40 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 form this Department dated April 7. 1999 The addition is approved with the following conditions: - 1. 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. 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. ML:kg CC:BI Very truly yours, D Michael Luke Public Health Technician DOS 17 - v iy ;i e�T y 1, i iq 1., t 7s Pwc f� S� PUTNANI COUP4Tr DEPARTN',E F HEALTH �i P.!� HOUSE PLAT Af'RR;CKED FOR e�z-q- t , Date C C 6 ao >� t 14 13e C i4l'1•T OF HEALTH HOUSIE PLAIM,-'l H) FOr BEDROON'l COU"',"If B E DFIG C'k - Signature & Titie Date —As A-- 61 A& " ,&,A C, I'ss q l� (L C JL& L ,1 OLA- 4 S•k x ; v k� t-z � rte �1V PUTNAM COUNT)" 'DEPARTMENT OF HEALTH HOUSE FLANS APPROVIED FOR BEDROOM COU ";T 0lpy; BE0- ,RC.fk', 'iS Signature & Tide Date �' �� v Li pill o.NS )PC 1 PLITNAMCOUNlYDEPARI HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY; 6EDR0011.113 -7 I? .1p �z �— L +t r- dw- .6 A4. 61t;lq Z ; f �jle� tool,,. - ir �J S ,I,L- la( 06 CA, e .?. ;4 �,41 , "L. • s'p'y !ts +:: ; �x. • r ., d 8 5/82:) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDIVUDAL ADDITION/REPAIR FORM SECTION A: GENERAL INFORMATION Name of Project 75 (T)(V) TM# Year of Construction Size of Parcel SECTION B. TOPOGRAPHY (Please check all appropriate boxes) I. ❑Hilly rxolling ❑Steep Slope L'Gentle Slope ❑Flat 2. ❑Evidence of wetland Clow area subject to flooding Bodies of water ❑Drainage ditches ❑Rock outcrop YES NO �. Property lines evident. 4: Water courses exist-on, °o "r adjacentto parcel: i� ❑ 5. Existing individual wells within 200ft of the existing SSTS? MK ❑ SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) 1. Physical character of existing SSTS area. A. []Level LMGentle �Slope r3Steep slope e B. ❑Well drained WModerately well drained ❑Somewhat poorly drained ❑Poorly drained C. Area available for SSTS. (Pri 'ary & Reserve) ❑Extremely limited Somewhat limited ❑Adequate _ft x ft is D. INSPECTION Date 9.3 1 �� Inspector 010 0 evidence of failure ®Evidence of failure ®Evidence of seasonal failure - - - - -- -------------------------------------------------------=---- - - - - -- -- - - - (Indicate North) v� '57 HOUSE n, (1) Indicate location of SSTS A. Size and type of septic tank Metal C B. Type of absorption area 1. Fields ft. 2. Pits gallons ®Plastic 3. Gallies ft. (2)- Indicatd- setbacks, -front street, backyard; grid-0d yard- dimerisibns . (3) Show location of well (4) Show location of driveway (5) Note physical features (steep slopes, rock outcrops, streams /wetlands) SECTION E. EXISTING WATER SUPPLY CIPWS ndividual well ® 61 Shared well IJXDrilled OCsing ®Dub g above g round COMMENTS: c r`� j• �o� s REPAIRS ONLY: Status: As Built Inspection Required: As Built Submitted: As Built Inspection Done: Inspector: (addren) 04/87/1999 09:10 9146262130 TOWN OF PV PAGE 03 lj � � * � .i+p.- .�',Y�.'9'J: ,j , �' %. !` {S � ' Vii. �: � j.. •.. � � � � T �' Y F ,•�' •..19d�' ►~1`�x'"1' 44.``'• e �•r ,. �� .;' .��'_ "i.v!,, .E. �,t � •d.'... '..., r�f_ ° %�' t °lee _weer . ....... ,. _. 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ASS \GNS LO-1 Il'1 �CD NiC_ STQOP 6R1U1 F0.AME ENS 0.'1 FuvcR 3S3.°IZ " .WELL CF _ 5 5 ate_: D0.1VL - � f lif�a 71 G.89 ov GVY PNLt00. i �Olf a n �5 i LDT {I C% 3 O 23. -17' TALL P PE i 0U \OO IN 0.AXLi 5 i 1 1 N 88' S4' 30" E TN \S MP\p \S COAT \i \CS] ONLY TD: W1LL \AN\ G K0. \ST\NC Dl1X. Lt�N COMMONWEALTH LAND T \T<E \NSURANCE CD MPPINY ST ANDl�0.� FEDC0.AL. DANY±1 \TS �ULU5%OV.S AND 00. ASS \GNS LO-1 Il'1 �CD NiC_ STQOP 6R1U1 F0.AME ENS 0.'1 FuvcR 3S3.°IZ " .WELL CF _ 5 5 ate_: D0.1VL - � f lif�a s5 i I h y e � F° v o% f9 OLL i P \PE SOU1\O - 71 G.89 ov GVY PNLt00. i �Olf s5 i I h y e � F° v o% f9 OLL i P \PE SOU1\O - Of�' tlti h 71 G.89 i 1 s� U' a n �5 i LDT {I C% 3 4 $ t i � f SV0.VS.Y NQ'FES: UKOEfLC.0.QUN0 1M00.0VLMFNT A0.,. NDT S\\OWN SVU1 PRLP0.0.E0 iC0. KRISTINE DU%Ukk NsEYL 0% uD0. A0.! ANY LQLAT\ONS GUAYANTEED BM TA \S S \TUATC IN TM.0 tL\LAT] OS W *Y' 00.LP]CME.Y.TS ,1i AM'Is AA! Ncc TOWN OF PUTRKW VRLLE`/ ` PUTNRW COUNTY RLFE0.Ltl�GE TO SUaDWISION OF RONRIHG BROOK LNV.L NEW yO MAP- 1 StcrtON K" SCALE 1 MW : ZO FLU KN?,MA b, 19gG 5 PUTNRM COUNTY LLE0.W'S F\LfD S U P. %J Ei IL O 131f Y MAP Xo. soaA. • PUTNNI�VALLEY G0. \D N0. 41.W - \ -HO �NLW� T. C.RRP.LLS SOOLUKOS P.L -5. NEW 400.Y. ST AT E U L. NO. 044V9N ' ' TE_lf'. 9W- 916 -1N21 RH \I\EDECK i.: B3 \- \-7i0 DEACON if Of�' tlti h ' i 1 s� U' a n �5 i n a 4 $ i � a C" I N I of x -tT7 I ---v • 1 0 -t OLT, K- 5=99 TUE 10:47 AM PUNAM CTY ENV HEALTH FAX Nu. 19142787921 . :1 ' ..A.,..F;,. ,�' DEPART OF HEALTH Division of Environmental Baalth Servieos 4 Geneva Read Brewster, Now York 10509 ` Tel. (914) 278.6130 Fax (914) 279.7921 BRUCE R FOLEY STREET 75- �SA tic S _ _ TOWN � V TIC MAP' # ©q 1 ° Dl L1— 6 0 01 NAME j t wLCc a PHONE u PcHD # MAMING ADDRESS 75- ?A hc SAieA ZJ -hc La's Zt DESCRIPTION OF ADDITION re �kexL NUMBER OF EXISTING BEDROOMS 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., 4 Geneva Rd., Brewster, NY 1050% Pbone 278- 6134. 1. Certified check or money order for $100.00 2. Sketches of existing floor plan (drawn to scale, all living area including basement) * Non-professional sketches are acceptable 3. Two zeta of proposed floor,plan (drawn to scale, with name, street, and tax trap #) * Non - professional sketches are acceptable 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and sep&c systems within 200 feet of the property fine. Contact this office with any questions. 15. Copy of Celt. of Occupancy from Town or Certification from Building Dept. with lcpl bedroom count of dwelling. QE= UsE Comments 10 0 —Davy Vj D0Q1Cj.A6 Own6r'-or Purchaser of Building BuilUirig -, . POnstructed by Loc'ation - Street* K M PY % (:7 i>C Building Type L.0 tj. o Muni ciball.ty (3 'Blo6k Lot GUARANTY OF SEPARATE SEWAGE, SYSTEM I I repr esent that I am wholly and co' mpletely responsi ble: for the loc-a,t-1b.h9 -workman,shipq -,material, construction and d.rainage• of the sewage :ditpoikl. system.. serving the above described property, and that. it has 'been c=6nstructed as shown on the approved plan or approved amendm.45,n.t. theret-o', "and in accordance with the standards, 'rules and regulatipn$, • of 'the he Putnam County Department of Health.. and hereby guaranty to th'e owner, his succes- sors, heirs or assigns, to place in good operating condition any part, of said systern constructed by me, which fails to operate te� for a period of two viowing,:the- date of initial use of the sewage-dispo Al years ii-qrqediately f6.1 s system, or any repairs ma-de. 'by me to such system, except where the failur,4­- to- operate ,properly- .i.s caused by the �`illful-or negligent act �-of 'th,e. '' - V 9 occu P.a:nt, of the.. huillding utiliz1hg the §ystemri The. undersigned, further' a.gr e-e,s 1C.o..a.c-66pt .. as conclusive' the em ­ t,erminatd-b; _e* ` - .. n �o�f 7.t-he�. D.i-r' Cto-r1rp.f* the biv,.tsi-on -of— vices of the Putnam County -DepcIrtmentl of Health as: ,.to 't-he .,..to wh-- ether or not failure of the systeni. to: 0'pera.te wa.-s caused by the. will ful'6r negil n -ge -i act of t he occupan 't of-, the. i.ldi, ng u tilizing the syste m - Dated this da'r,o.f 0c, Sign a ture Title —6—Ult P4A (If corporation, 'give name And address) THREE (3) COPIES ARE .REQUIRED 1WqTH THREE (1)'COPI ES OF FINAL PLANS.'BEFORE C ERT IFI CAT E OF COMPLI SN.WILL BE ISSUEDe GUAIR-ANTOR, 1S LwQU TIR ED TO FILE - NOTICE OF DATE 'OF FIRST M5k, OF SYSTEM. .1.r.onmentol 19'alt, Putnam County Deipartment� of Health Division, of Env h . S e c iN�1J1:. _laic- 1 1 +1 •: AND 1M . Well at,, • oun y Of r� e- o. ace age or _._ Uiuner 2a P4 ; �dd F, lTep .of we l iaine er eld a —swell di Kinf ecte Y yes or no -- _;ioun tT411 seal l�mt. of; cain above: round Be1.ow _. g g r packe' 9 cn", grout f , eme t Draw a ,:::11 diagram in the space provided telow and show ".;he depth of c. sing, the wc11 s ,al kind and thickness of_ forma; ions..y enetrated, water bearin o" rraaL &J—- ns, dia iet;er of drill holes' twi'th dotted lines and casings) wit i solid linedla ,q E .. _. 7' , ;WELL FURNaaTIUNS YE, :TI-il_�D REi`:T iameter, in:. , epth Find, thidkness# and T ype of well, _ / in ft,'' if watz:r bearing drillin mit_i.od Grade Wa dynamited?� ,; s.well S T_�3T PUMPING 2>. } C- 2 Details. �1 -.. __..... *:. .. Static water:... level, in ft. 50 _ �t-i 4low _rade { . _ ...._. _..__.._ i .. :pump ng..r.ate; gpm r ' 75- . Pumping level in _... it, below rade s -- DUratiop_qf, .. .,: r t t 3:n S f - ; JJ %7�i�1 Clear..-- u x d ecom end 'eT. dept o�f pua- in ::.. wr•11.:..f.eet ..b, low trade' 200 sizo mm afi;$T6iz e. Length of screen ft w, Dam of y screen i 2:50 :.. , Type of screen Screen i Goenin s x _ corrUto uI;T i ').raw a sketch of the properay on the . back , of, this_,:,.sheet:.locatio DrilZzn start :d - (i..m Tet d P 'i:_L: .ti `.:D S S AL Well Dille UNAr ' OUR HEALTH 4 lY 512 W�k W6 Sdrvk&,�: Cirhhel;', N., Y. 1, 0 ":`-DiVisibn-"&-E )i;h4ht6l Health , -4, --CONSTRUCTION .PERMIT �.' 1D DISPOSAL YStE M . J A ALL t.` Town., oF Stmage G to ni, Job 7 Owner ; r P 42 A►'-ta r,es m of Area Number of Be rooms �.sice > Square ;Feet.` age'System to - consist 8f Z' lineal To be constructed by a er U Iv. 1'41 Ar". CE q lrlrvat6 'Supply ' ' ti ­ 9, ?e drilled. by.. Address '� Ilk" + Other PR I system In idn,of-tfie-pro'- age disposal I 'represent that 1. arri-whoill ked rate w-": 616i d-T at-ions, constructed -s�Ao t. 0 nt,.tKer6A'd �and jh`,aciEdrdakiicb ot ,,P u t a� 't, Commissioner above described will be c County - Department 'of ft' ion th i icate,�ofCbnstruc ion -ompiianci�.i—A'tis'f'a'dt'bry to. H 66 submitted- to the and -6 ishi� 'th owr�& iii4r assigns by.�',64,builder, that.,sa id builder Will bfthe issu- .,Place'in good ,operating- cbnditiok, em, dUrinj �thijpefi!;�! ,qf,�tWj (g);Y!�' 119w!ng tl ance o,i' t he, -approval­r1 jo� � .'f-, :t h et Certif — ka . -Co - 1l* a the o6 ( i Ste 'or-a ny're)�'�tth6eetb�2)�-thi*f'�f6" d"drillid weWdesc rJbec-a b;o Vi Will be located as shown on t6e 4pprov pla a . cordance wt p and r gula iMon—i hd Pu in am o W'Heiiti ' Date '° ;P0 E Ot.A' License , N .APPROVED ,Fo'i:z'cb T UCTION'­ ­ - "��- V P�w .8'xa& t i ear : from I issued - . unless consfrtcii h of'the-'building has been lneer: taken and is revocable f& - ibdif;5­ I ore s f Hearth Any, ha e or construction z requires a1 new it Apprbvidi disposal tl(mesii A a e'wa t r. -V Dat 015 7177 us To _ d r G � iY� "sue -3o 276 -`� G SOIL PERCOLATION TEST DATA REQUIRED TO BE SUB''! TED G'11TH aPPLIC. TION 1 , Hole Number CLOCK TIME 2 PERCOLATIOY PERCOLlT10 "N PUTNAiI COUNTY DEFz?T: '`T OF 'r. ;.LTH Elapse Time Min. re- .:e,.sn/+., Y.'xa.0 . :..ywP4.sW- :w.::`Ov.= Kr..- ..e:.vF -r. xs;. - t,xm.YS^.,LS. -.. -aV s.. .�.. r,.rea• .u. tom:+ -- �.+Y-- +.r'*,a4v sd xa_ ai ' DIVISION OF E \TVIRON-M, aL HEALTH .- .4:cOax= C+..+:- •ax, -s. SEH WICES _i ♦Y -rr_ _3. .a e? a s.-. s.. a DESIGN DATA SHEET - SEPARATE SE,� -AGE SYSTE_Y FILE N0: . Owner t —'.A0 05 ICY{ "DL)JjC J ,DISFvSaL Address ! lvg�ck1*� S7' Lod ate.d at (Stfiree t),` ly- 0 1- 4i3Block. A- . Lot !% (Indicate nearest cross street) . _ - Manic pality c�T�/�lVl :YJ4L.z..� :; tershed a �ZSf�e "' A SOIL PERCOLATION TEST DATA REQUIRED TO BE SUB''! TED G'11TH aPPLIC. TION S ` 5 1 , Hole Number CLOCK TIME 2 PERCOLATIOY PERCOLlT10 "N R n No. Start Stop Elapse Time Min. Deb t to t':a Len (rater Level From Ground Surface in Inches Start - Stop Drop in Inches Inches Inc::es Soil Rate . Min/in.drop _ ,,, .3a -sue;z� S ` 5 1 , 2 3 Notes: 1) Tests to be repea ted at same depth U7til a pp, roxi -ately equal soil.; rates are ob- tained at each percola �ion test hole . all data to be submitted for review. 2411 30 36ft 42-- 48 S-41f I off '30 °add 04 um M11 66!f 72:* 78-f 4- .84 INDICATE LEVEL AT 4,IICH GROUND MATER IS ENCOUNNTEERED, INTD,ICATE­LErVEL* TO WHICH tkTATER LEVEL RISES AFTEERi BEI 'NO ENCOUNTERED S [A DE E B TESTS.. Y--- Date. jul.S: zVi" Soil Rate Used `tin /1 "_ Droo: S. D. Us.anic Area FIr o-,,r j d-d No. of Bed--f-.00.-..s 7-4/ Septic Tank Cap-acit ;16e Gals. "y 0 e 0ffl40A1Rj--' L -Lfl trench. Other Absorption Area Provided B�l i d L 36 Name STANLEY J--- U, N111 L111 ro Address 130,E 4 EAL on mz- &4U-Z0143 0 PUT NAM COUNTY DEPARTMENT OF HEAL Soil Rate App-roved-, Sq. Ft./Gal. Checked bv ? TEST,PIT DATA REQUIRED' SU -I T. 0 BMITTED H: APPLICATION, DESCRIPTION 0 F 0-1 L S- E- 0 U. T N ERED E S T HOLE 2- --S DEPTH HOLE NO. HOLE N X HOLE;, N. eF 61t 12 rf 2411 30 36ft 42-- 48 S-41f I off '30 °add 04 um M11 66!f 72:* 78-f 4- .84 INDICATE LEVEL AT 4,IICH GROUND MATER IS ENCOUNNTEERED, INTD,ICATE­LErVEL* TO WHICH tkTATER LEVEL RISES AFTEERi BEI 'NO ENCOUNTERED S [A DE E B TESTS.. Y--- Date. jul.S: zVi" Soil Rate Used `tin /1 "_ Droo: S. D. Us.anic Area FIr o-,,r j d-d No. of Bed--f-.00.-..s 7-4/ Septic Tank Cap-acit ;16e Gals. "y 0 e 0ffl40A1Rj--' L -Lfl trench. Other Absorption Area Provided B�l i d L 36 Name STANLEY J--- U, N111 L111 ro Address 130,E 4 EAL on mz- &4U-Z0143 0 PUT NAM COUNTY DEPARTMENT OF HEAL Soil Rate App-roved-, Sq. Ft./Gal. Checked bv Gentlemen: i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of 1`i ,4 /yC /S dV . �12 ✓1VC 4AI �f2u: Located at ) //V/.-/ RW. L �t•,� -B - - • Block `TA-7(-, PI1W J & WN This letter is to authorize z STANI EY I UNDER a duly licensed professional,.engineer or registered architect (IndicaT- to apply for a Construction Permit for a separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated by the Commissioner of the'Putnam County Dcpa.rtlllGllt of Hez3iti, and to, sign all riec:essary papers on my :behalf in connection with this matter and to supervise the construction of said v system or systems iii, - ,conformity with the provisions of Article 145 or 147, Education Law, ,the Public Health Law, and the Putnam County Sani- tary Code. F r � f Countersign . P.E. � 2 STANL 10 (Seal) AddreGM 2657 �'I. Yo 10 501 245 -2645 elepnone Very truly ours, Signed. `F2 <�!+ Owner of Property `address CiZJ —� P one N" R�\�n V, " 41,4zerl e 4 � . s :o Gentlemen: i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of 1`i ,4 /yC /S dV . �12 ✓1VC 4AI �f2u: Located at ) //V/.-/ RW. L �t•,� -B - - • Block `TA-7(-, PI1W J & WN This letter is to authorize z STANI EY I UNDER a duly licensed professional,.engineer or registered architect (IndicaT- to apply for a Construction Permit for a separate sewerage system; to serve the above noted property in accordance with the standards, rules or regulations as promulgated by the Commissioner of the'Putnam County Dcpa.rtlllGllt of Hez3iti, and to, sign all riec:essary papers on my :behalf in connection with this matter and to supervise the construction of said v system or systems iii, - ,conformity with the provisions of Article 145 or 147, Education Law, ,the Public Health Law, and the Putnam County Sani- tary Code. F r � f Countersign . P.E. � 2 STANL 10 (Seal) AddreGM 2657 �'I. Yo 10 501 245 -2645 elepnone Very truly ours, Signed. `F2 <�!+ Owner of Property `address CiZJ —� P one N" R�\�n V, " 41,4zerl 1 0 vitae -7i t, NO to, jQ ct iA rn Ai - - Ffl X WAXle Zo 1: 71, 5 07 F Lo T; Lo V1 V 'ok Doi ol 10 _14 10 4 iT iVJI` -V u