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HomeMy WebLinkAbout2393DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 42. -3 -12 BOX 21 I I I ,. -6, -- J 6, x}61., I I 1 I . I - - r r % t r �� L r % - L, , , -6, -- J 6, x}61., r r 02393 CONSTRUCTION PERMIT F Loca�eci. at,- /�. //L= '''i1.fiLG Subdivision/74p, .1f �HNOJ Owner— -1 Building Type =t ''. PUTNAM COUNTY DEPARTMENT OF HEALTH 1 r. Division of Environmental Health Services, Carmel, N. Y. 10512 i SEWAGE DISPOSAL SYSTEM _ o— ;N /'-' '� , � i �i own or village ,�.00k .FiJ�•,__._ - �,PCF`C �i�% Lot – Job,, Address'tL�l _ •�' Lot Area — Number of Bedrooms Total Habitable Space 41 �'fi�1 f ` Square Feet Separate Sewerage System to consist Hof Gal. Septic Tank �� lineal feet Xis .-- width trench To be constructed by �° �/ �3 Address ) 4o 7_AA VV IIA4 y Ali ' Water Supply: Public Supply From __�Zprivate Supply to be drilled by Add Other Requirements a0/' v`7Wf4 1 represent that I am wholly and completely res' above described will be constructed as shown o County Department of Health, and that o be submitted to the Department, and a place in good operating condition any ance of the approval of the Certificate nstr will be located as shown on the approved n a d th County Department of Health. Date " Address �� .. APPROVED FOR CONSTRUCTION: Thli app 40 revocable for .cause or may be amend ii or modifi requires a new permit. Approved or disposal of don A Date + By I location of the proposed system(s); 1) that the separate sewage disposal system there to and in accordance with the standards, rules an regulations o e Putnam sate of Construction Compliance" satisfactory to the Commissioner of Healthwill i ed th'e', owner, his successors, heirs or assigns by the builder, that said builder will m d'��yy,,44'�ng the period of two (2) years immediately following the date of the issu- e oplginal system or any repair hereto; 2) `that the drilled well described above ON i /accordance with the�st Bards, rules and regu a ons of the 'Putnam P.E. 7 R.A. License No. thessued unless construction of the building has been undertaken and Is sry by the Co;y""__1_ss19ner of Health. Any change or alteration of construction ge and 'r pr ate supply only. Title '•'' ' we- PUTNAM COUNTY DEPARTMENT OF HEALTH Division of<Environmental Health Services, Carmel, N. Y. 10512 �._CONSTRUCTIOM PERMIT 'FOR 'SEWAGE - DISPOSAL _SY9rEIVI � � Q j,��,I QiC T ILown or Village I� Located at OA , section hi? Block 67- Subdivision Lot 1' X.-- 4 ob Owner L� Address GL O Building Type .i1® �N �" Lot Area ��' ��L i Number of Bedrooms Total Habitable Space ✓�2�/ Square Feet Separate Sewerage System to consist of Gal. Septic Tank /' lineal fee X J ,/ /width trench To be constructed by 411 r Address ^+ Water Supply: Public Supply From Private Supply to De drilled by 0 _ Address Other Requireemmentts,� I repr6atf -I t I am who dyf. nd c�o}mplete responsible for tK above described will be constructed as'shown on the approve County Department of Health, and that on completion t be submitted to the Department, and a written guaran Jl place in good operating condition' any part of said se ;Jtl l ance of the approval of the Certificate of Construct i q� pli will be located as shown on the approved plan and that sa y(9 wil County Department of Health. the proposed system(s); 1) that the separate sewage disposal system accordance with the standards, rules an regu a ons o e Putnam 1 uct,on Compliance" satisfactory to the Commissioner of Healthwill &I..issuccessors, heirs or assigns by the builder, that said builder will ertod of two (2) years immediately following the date of the issu- m or any repairs thereto; 2) that the drilled well described above with the stancidZds, rules and regu ffrons of the 'Putnam Date dt, fo •<.`. P.E. R.A. Address '40i License No. = �2,,Z 2,6_� APPROVED FOR CONSTRUCTION: This approval expires on fr�e issued unless construction of the building has been undertaken and is revocable for .cause or may be amended or modified when considere y the Commissioner of Health. Any change or alteration of construction requires a new ermit. Approved for disposal of domestic sanit y sewage and /or ivate water supply only. // Date BY - >!.��� ��`�f1i Term 14 /JAhE i P[T'g'1VAWCOtJ1�1TY DEPARTMENT OF HEAH.'�� rvices, Carmel, N. y. 10512 17ivlsi car Town, Cr Village CERTIFICATE OF ':CONSTRUCTION j;QMPLIANCE FOR SEV�AGE DISPOS�►1. SYSTEM / �/ CERTIF 1 R %y-1- A � Block Sc :> t — , 1A � 'Cv l-'o" OJa ; . Job Located at Lot '! Owner 1 >`01411'- Address l., *y Separate Sewerage System built by 1 lineal Feet X s era y Consisting of -�"-- -Gal. Septic Tank other requirements 0 Public Supply From water Supply' 9S61 a,f Private Supply Drilled BY Al Uy- ° ,� Date Permit Issue Address O�L No. of Bedrooms_------ - width trench Building Type p = Has Erosion Control Been Completed? n on the plans of the complet- 7 (cones E 4 U Ith j as listed serving the above premise j I certify that the system(s). ` attached), and in accordance with the standards, rules an za d Cert o. Date Address I y r person occupying premises served by the above syste s) s a Any P from such usage. Approval of the . conditions resulting 1 shall C available and the approval of the private water eY judgment o subject to rlpodification or change when, in the ju BY Date as show �e Putnam ie permit issued by (ion as may be necessary to secure t ,ecome null and void as soon as a a `pubi ter supply becomes a n vocation, modification PEEKSKILL MEDICAL LABORATORY 879 Crompond'kd -. 96iclay 'Plaza Bldg. X,-A' p t. 1 Peekskill, New York 10566 CITY, epar men o ea n of any unsanitary tary sewer becomes Such approvals are s. necessary, / PE 7-8777 111 RESULTS OF EJtARNIP1AYlON OF WATER DATE COLLECTED 111 /0 DATE RECEIVED r/ LAGE, TOWN &/OR NAME OF SUPPLY DATE REPORTED I POINT -"/ "" 761— 'del/ L PER ML: (Agar plate count at 35 C). COLIF�ORM G�RCO/UP (Most probable No, /100m1.) S, TAL JTS - ppm NITRATES (as N) - ppm IRON, TOTAL - ppm. (F) - mg,/L Irhese results indicate that the water was (lecs - ppm of a satisfactory sanitary quality when the sample was cIsallected. `✓ A. H. PADOVANI, M. T. (ASCP) If, A PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES UNtY OFFICE BUILDING, CARMEL, !N. Y. 10512 DESIGN DATA SHEET-SEPARATE 'SEWAGE DISPOSAL-SYSTEM FILE NO. Owner L_�AR,4ef iLa Addres's Number CLOCK TIME 4//, Located. at (Street Block 2 Lot nuicate ne-a—re-H —cross 'street) Municipality/ °!' Wate rshed ec�o SOIL PERCOLATION TEST DATA R1 TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Eiapse Depth to Water Water Levei No. Time From Ground Surface in Inches Soil Pate. Start -Stop Min. Start Stop Drop in Min./in drop Inches Inches Inches zg _0 4- _3 3 9 S -2,:) 3 72 2-- 2 Z z lexjj- /A/ / W, 4 Notes: 1) T6sts to.be -repeated at same, until' approximately equal soil rates are obtained at each percolation test hole. Ayy data to be submitted for review. 2 ) Depth measurements to be ".. made from top of hole. 7811 9 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY Date 7- % f� DESIGN Soil Rate Used Min/l "Drop: S.D. Usable Area Provided No. of Bedrooms ,S Septic Tank Capacity . Typeiiec� Absorption Area Pro ded By - L. F. x24" 3�— . ,.f'` width trenc . — Other i' Address THIS SPACE FOR USE BY HEALTH DE Soil Rate Approved Sq. Late TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES D8PTH HOLE NO. P HOLE NO. j' HOLE G.L. 'NO. s g JiD�t'?.� •�f �/r�.v 611 12" 4 18" �a w 2411 3011 y 3611. ti 421► 48" h 54" 6011 A j 6611. .� 7211 7811 9 8411 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY Date 7- % f� DESIGN Soil Rate Used Min/l "Drop: S.D. Usable Area Provided No. of Bedrooms ,S Septic Tank Capacity . Typeiiec� Absorption Area Pro ded By - L. F. x24" 3�— . ,.f'` width trenc . — Other i' Address THIS SPACE FOR USE BY HEALTH DE Soil Rate Approved Sq. Late TOWIT OF PUTNAM VALLEY WILL DRILLERS LOG AND REPORT ]PEEKSKILL HOLLOW ROAD,, WELL LOCATION street section block lot MR, MIhO� WELL 0,414M name address city or. town ANDERSON WELL DRILLING R.D.#3 NARGER ST., PUTNAM VALLEY, N.Y. tO579 WELL D-RILLIM name address city or town OT.,,L Dla)"H OF WELL 3001 Feet T. —ep th from 'Give description of formation pen;trated, such as: peat, Grownd ")Urf ace sand, gravel, clay,hardpan, shale, sandstone, ranite, etc. Include size of gravel(diameter and sand cours.e)', --ure icolor of.material,,--struct. (Loose, packed, cemente'a';-'S'6.t't-"'hii:bd)'-.(E:it."Oft, 27 at-z fine, Packed ellow saud, 27 ft to 134 ft gray granite) lirre-F —tc;--7ie—e-= 'FoIrmation Descripti'ont Sketch exact location of well to at least two Dermenant Lbndmarks hardpan 10 3001 bedrock shist* to v-4 j.1 Completed 9/5/74 Date Of Report Well Driller. signature Bailed (Measure from 1 1 d ) surface Lengh: 211 feet, or Pumpedj+Hrs. Static ft, Make: When Bailed lot Diameter: 6" Inches Yield: 4 GPM :)r Pum ped Len gth Ft ize Kind: steel :ftDiameter Inf. OT.,,L Dla)"H OF WELL 3001 Feet T. —ep th from 'Give description of formation pen;trated, such as: peat, Grownd ")Urf ace sand, gravel, clay,hardpan, shale, sandstone, ranite, etc. Include size of gravel(diameter and sand cours.e)', --ure icolor of.material,,--struct. (Loose, packed, cemente'a';-'S'6.t't-"'hii:bd)'-.(E:it."Oft, 27 at-z fine, Packed ellow saud, 27 ft to 134 ft gray granite) lirre-F —tc;--7ie—e-= 'FoIrmation Descripti'ont Sketch exact location of well to at least two Dermenant Lbndmarks hardpan 10 3001 bedrock shist* to v-4 j.1 Completed 9/5/74 Date Of Report Well Driller. signature W4,,ZZ. , 5 /11 `Lo D ' �/4r r! �G !. / /l ✓Fif'` �r L[.E =�/° ...; . Owner or-Purelaser of building Municipality Building Constructed by n��,c� %`�f . r� Location - Street Block 4 Building Type Lot �- GUARANTY OF SEPARATE SlIVAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on. the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guaranty to the owner; his successors, heirs or assigns, to place in good operating condition any part of said system constructed by .me which fails to operate for a period of two years immediately following the date of initial use of the sewage disposal system, or any repairs made by me to such system, except where the failure to operate'properly in nAllPPH ht thn tai 11 fill nr. nagl i, crnnt nnt. of tl-ip .nr rm n=nf- of -Flin . hii i l rli ncr 7.; 7.1 ncr . . The undersigned further agrees to accept as conclusive the determination of the Director of the Division of Environmental Health Services of the Putnam County Department of Health as to whether or not the failure of the sys.tem .to - operate teas• - . e.atasod..by -. thee -�ailr h'ar negligent -- -act- of -the occupant -.&f the.:bui-1ding •utilizing• -the - • system. Dated this 'go day of 1 4.2c # 19 7J - Signatur / Title (if corporation, give name and addrES's THREE, (3) COPIES.ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE. OF DATE OF FIRST USE OF- SYSTEM. Division of Environmental Health Services, Ritnam County Department of Health r A a t�4 air � ry t / / -, 'APPRO� rt f. rr ,. f Cfcc aat, �a�c Tea RIAR'2 51 l I •.11.A A V'... T "I i MF1LL1F n� ' 3 tT { n11S iS to "ef ify that tln di pml sss "4ai , r� sors;rucke doted r t; _'rai tfi E::. .rtv'la Zi�S m f�,��r.t ry 'i t:;re it k4 ?A I.4�UN ever. !I,;,, l sceotdancn �r�; ;t rules s loons of Lha utnaci county TIC lo= 3r:.cWn ,G-,�-ec'7 :- " -/L.. ` r 412, //9/4r C 07 1 l l 1 O x sv 145 1f�?ZJ •. �.. �r^ NO I I i Re: Addition — A- 140 -14 No Increase in Number of Bedrooms 971 Peekskill Hollow Road (T) Putnam Valley, T.M. 42. '-3 -12 Dear Mr.- Cerqueria: This Department has received and reviewed the plans for the proposed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the approval: stamp from this Department dated October 2, 2014. 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. The approval is for the modifications only acid does not validate any construction shown as existing that has not obtained proper approvals from other agencies having jurisdiction. 5. This approval is valid for two (2) years and expires on October 2, 2016. Any permits or variances required under the jurisdiction of the Town of Putnam Valley are the responsibility of the applicant. If you have any questions, please contact me at (845) 808 -1390 ext. 43261. Respectfully, Gene D. Reed Principal Engineering Aide GDR:cml cc: BI (T) Putnam Valley ALLEN BEALS, M.D., J.D. a 4 „� MARYELLEN ODELL Commissioner of Health County Executive' ROBERT MORRIS, P.E., MPH Director ofEnvironmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278-7921,..,. October 2, 2014 Jose Cerqueria' 971 Peekskill Hollow Road Putnam Valley, NY 10579 Re: Addition — A- 140 -14 No Increase in Number of Bedrooms 971 Peekskill Hollow Road (T) Putnam Valley, T.M. 42. '-3 -12 Dear Mr.- Cerqueria: This Department has received and reviewed the plans for the proposed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the approval: stamp from this Department dated October 2, 2014. 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. The approval is for the modifications only acid does not validate any construction shown as existing that has not obtained proper approvals from other agencies having jurisdiction. 5. This approval is valid for two (2) years and expires on October 2, 2016. Any permits or variances required under the jurisdiction of the Town of Putnam Valley are the responsibility of the applicant. If you have any questions, please contact me at (845) 808 -1390 ext. 43261. Respectfully, Gene D. Reed Principal Engineering Aide GDR:cml cc: BI (T) Putnam Valley ALLEN BEA]LS, M.D., J. D. MARYEL]LEN OIIDElL1L Commissioner of Health `M County Executive ROBERT MORRIS, P.E. C.� f�, —�i� Director of Environmental Health I�+-'-J DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 ADDITION APPLICATION - RESIDENTIAL ONLY Owner's Name: �� �� � _// Owner's Phone �� #: �l � CLI� • j's V� 1 N � /J b Site Address: 02/&� jjt gau�L) Town: L)AQAkW Tag Map # Owner's Mailing Adss: ,S4 J�- Owner's Signature: Description of Prop )fse9d Addition: e_ *Number of existing bedrooms: Total number of bedrooms (existing + proposed): * (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 Department of Health, 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 808 -1390. 1. Certified check or money order for $100.00. 2. Two sets of sketches of existing floor plan (drawn to scale, all living area including basement, to be shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin HA -1) 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) 4. Copy of survey showing all well and septic locations on the subject property to the best of your knowledge. Contact this office with any questions. 5. Copy of Certificate of Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE " COMMENTS Rev. July 2013 5. ALLEN BEALS, M.D., J.D. Commissioner of Health R013ERT MORRIS, P.E. Director of EnvironmentalWealth DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845)'808-1390 Fax # (845) 278 --7921 MARYELLEN ODELL County Executive Town Le Bedroom Count & Pro po1rl sed Addition Status (Owner's Narnre) Talc Map #.~ Address: �� �P�CS I A _ 4 I Town,_ � Year Built: P-14 According t :oblapliance ords maintained by the Town, the above noted dwelling, is i with Town Code. Is not in compliance with Town Code. The Legal Bedroom Count is: This i ifbnnation has been obtained fr o Certificate of Occupancy: Other: U The plans for the proposed addition are considered: ✓ Additions to existing house only Tcardovm and/or re -build allowed undet Town Regulations Building Inspector Date 5. �a A� , 52 �Z N 46° 09'36" W 73.25' N44 °53'3! "W 49.51' BUILDING FOOTPRINT SURVEY SITUATE IN THE TOWN OF PUTNAM VALLEY PUTNAM COUNTY s NEW YORK w D SCALE: 1"=50' SURVEYED: MAY 29, 2014 s. Link Lm Land Surveyors P. c. 21 Clark Place, Suite 1.8 Phone 845-828.5857 Meho a0 NY 10541 F 84 \ - yob y _ 0 C) �G 0. ^��< <o J N� � N T W a� O • PREMISES ARE DESIGNATED ON THE TAX MAPS FOR THE TOWN OF PUTNAM VALLEY N 3 I ° 00' 18" W SECTION;42 BLOCK; 3 LOT;12 38.38' . • \ Street Address: 971 PEEKSKILL HOLLOW ROAD • PROPERTY AREA: N 33° 10' 29" W 0 THE PREMISES SHOWN HEREON DESCRIBED IN DEED RECORDED 52.93' - IN THE PUTNAM COUNTY CLERKS OFFICE UNDER LIBER 1676, PAGE 98 • SURVEY IS SUBJECT TO ANY STATE OF FACTS WHICH AN UP -TO -DATE TITLE EXAMINATION MAY DISCLOSE. • THE OFFSETS SHOWN HEREON ARE NOT INTENDED TO ESTABLISH PROPERTY LINES FOR THE ERECTION OF FENCES, STRUCTURES OR ANY OTHER IMPROVEMENTS. 0 ENCROACHMENTS BELOW GRADE AND /OR SUBSURFACE FEATURES, IF ANY, NOT LOCATED OR SHOWN HEREON. 0 UNAUTHORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF SECTION 7209, SUBDIVISION 2, OF THE NEW YORK STATE EDUCATION LAWS. ° ONLY COPIES FROM THE ORIGINAL OF THIS SURVEY MARKED WITH AN ORIGINAL OF THE LAND SURVEYOR'S SEAL SHALL BE CONSIDERED TO BE TRUE VALID COPIES. ° THIS MAP WAS PREPARED FROM AN ACTUAL FIELD SURVEY CONDUCTED ON THE DATE SHOWN AND THAT SAID SURVEY WAS PERFORMED IN ACCORDANCE WITH THE EXISTING' CODE OF PRACTICE FOR LAND SURVEYS' ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. PREPARED FOR: JOSE CERQUEIRA P - . ex 5-621 -0013 N78 °31'57 "W 1 2.83' Z 0 N p ERIK J. LINK NEW YORK STATE LICENSED LAND SURVEYOR NO, 050542 R 0 (O s ROOF OVER 9 WOOD DECK SLATE \ PLAT.h STEP SDP 0 �O I, COPYRIGHT 2014 LINK LAND SURVEYOR P.C. ALL RIGHTS RESERVED. THE UNAUTHORIZED REPRODUCTION AND OR DISTRIBUTION OF THIS DOCUMENT IS ILLEGAL, AND IS A VIOLATION UNDER UNITED STATES COPYRIGHT LAWS.