The URL can be used to link to this page

Home My WebLink About2513DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 51.14 -1 -36 BOX 22 Is i m Is :1; NJ r � �rf 02513 R c W Y Or ^T ' S NAME L 14, RA6rA- / PHONE SITE LOCATION Lam) J3 40 VS C 1qd , Zvi# -- MAILING ADDRESS N6* m V4 c Le- V , d , if i PERSON INTERVIEWED PCHD Canplaint # Name & Relationship (i.e, owner,tenant, etc.) - DATE TYPE FACILITY PROPOSED INSTALLER c.v,¢/� -p �ypz.9�r /� T G,O y i� (jY �IL __ SSPHONE �Z 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. F F X (S 17 /Yeg' S -rF,eL ��°lC � 1 1 t f / i �l�t/ �C�U � 6 r -rte- i ce° << Z_r, G :47';,c- D F_1Cf 57t n ►� S Y6 Sny 41-t- 13p� V &C/,6P e_ "M c Disapproved Proposal approved with the following conditions: wIT*� /Y .. 19/vuL P b 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed canponents tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam..x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, reported age,,l1t of owner agree to the above conditions. NATURE TITLE DATE / FUS: WAte (PAD); YeUc w (fin HI); Pink (AAalicant) PUTNAM COUN'T'Y HEALTH DEPARTMWT DIVISION OF ENVIRONMENrAL HEALTH SERVICES PROPOSAL FOR SE59M DISPOSAL SYSTEM REPAIR ' S NAME o e 46+ -p -4- C 14C C � Man SITE LOCATION 140 L L y 6 9-0d Sot- Rct 2(, o y .- f- 3& MAILING ADDRESS Py T NAB AN- V 4 L� %, r& V PERSON INTERVIEWED PCHD Camgplaint # �d 7 Name & Relationship (i.e, owner,tenant, etc.) DATE v O R TYPE FACILITY PROPOSED INSTALLER w ,q'pp (g -A-6 C & Pa-16 4VO /3" PHONE S'z 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 fram licensed professional engineer or registered architect. C,e r y cf re fzo 0 %,v el C «` l u Ci AlACA i Proposal app ;,Q,,1 Inspector's Signature & Title Proposal Disapproved 12 -h h Date proposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed components tied to two fixed points (e.g.,hoise corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, r reported agent of owner agree to the above conditions. SIGNATURE TITLE S y*,i— DATE iP1F�a ftte (PCHD); YeUc w (fin EI) o Pirk (AppUamt) el f+4(2 0 41y" L"13 tf 1. S ri- u T-N. fj-/Ik Ll r4 LL C" L T: v )F by ---�� uG�v� y 1 -.100C 5 5 . -r4 P - K Lf 40 0 iL 46 3 Lt7-7 . -r4 P - K OTO iL 15-1 � f f . Architecture Interior Design @Nmw0wr Planning 1949 Route Nine GARRISON, NEW YORK 10524 - �� WE ARE SENDING YOU 9(/Attached Under separate via > -/ O Shop drawings � �� Ph�s 8KPlons 0 Copy of letter 0 Change. order � /�\�� D ��u u ��u�� x�/u- UU�/�lU\J��U0Ju U V11 the following items: O Samples O Specifications ' -THESE A RE '--------- '�'�-'~- ` '-` f� '-�-- '--'----'--- --~�-^ '-- -�~-- - —'------ '--��----- � « approvu| O Approved uaoubmh1od O Rasubm�_oop�y�nopprovu Fox your use O Approved asnoted O Submit -_-_----' copies for distribution Forveview and comment O FORBIDS DUE O PRINTS RETURNED AFTER LOAN TOUS REMARKS " o COPY TO if enclosures are not as noted, kindly notify us at DESCRIPTION ME -THESE A RE '--------- '�'�-'~- ` '-` f� '-�-- '--'----'--- --~�-^ '-- -�~-- - —'------ '--��----- � « approvu| O Approved uaoubmh1od O Rasubm�_oop�y�nopprovu Fox your use O Approved asnoted O Submit -_-_----' copies for distribution Forveview and comment O FORBIDS DUE O PRINTS RETURNED AFTER LOAN TOUS REMARKS " o COPY TO if enclosures are not as noted, kindly notify us at � F E PUTNAM COUNTY HEALTH DLPAtitG •..., '`' :•i. ;'t (.. {.+.,......w a. ..•: bi `� «: +„'i .`!,,,, DIVISION OF HEALTH ...SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OWNER'S NAME � fi ~ t"i1 r PHONE '" �` ytz SITE I=TION 14 ti ', L v r'y ii au 5 r: d TM# d a w 3 MAILING ADDRESS u -r q PERSON INTERVIEWED PCHD Complaint # qj . Name & Relationship (i.e, owner,tenant, etc.) DATE, r TYPE FACILITY: PROPOSED INSTALLER j40 , p4 � j p3 b r ik r ��✓ :, <� it c .off PHONE Proposal (include sketch locating all adjacent wells)z 4- 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.' V'ej VV � F'�.r[,. /{/5 I� r f r fJ Ij JOT V L .41L 1i r Proposal approvd) { Proposal Disapproved fi Of, _ L Inspector's Signature &.Title . ... _ Proposal awroved with the following . conditions: 1. Procurement of any Towm'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 canponents tied to two fixed points d. System description (e.g., 1250 gal. concrete septic tank, drywells surrounded by one foot + gravel). e. Installer's name and number. Daite (e.g-,house corners). three precast 6' diam. x 6' deep 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, o''r reported agent of owner agree to the above conditions. SIGNATURE . _ w .. ,:x .. I n •.� r'.n ; ... TITLE ,+`` Ca a :t, • . DATE :9; :- /v r +r . . 1: WUbe MD); YeUAw (fin ED; Pink (Aplia3nt) Public Health Director DEPARTMENT OF HEALTH W 1 Geneva Road • Brewster, New York 10509 LORETTA MOLD Associate Public Flea Director of Patlent Eavironinental 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 . ADDITIONAPPLICATIM MM1D NTIAL ONLY) .STREET i"D �a°�� C ➢® �/� . TOWN g . . T'X MAP# ®� o e NA 4) 9W IDAt PHONE �° �} •��ID PC11D MAII,ING ADDRESS -a 7 - li /(� Y. .0 PE�rSCRIPTIONo OF ADDITION 1W.— 1 *UN BER 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 -w(th applicable sections of the, _:. n ' .. ;...... -MY. ourty -S nits. -y Please submit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, Phone 278 -6130. 1. Certified chock 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 sets of proposed floor plan (drawn to scale, with name, street, and tax map 9) Won -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 sepric 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 BFhomegttidelines 13RUC4 1L rOLI 'r- Public Health Director LORETTA MOLINARI R.N.. M.S.N. Associate Public Health Director Director of Patient Services DEPARTIVWNT OF -HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax(845)278-Ml Nursing services (845) 278 - 6S58 WIC (845) 278 - 6678 Fax (845) 278 - 608S Early laterventiod (845) 278.6014 Pradooi (84S) 278 -6082 • Fax (845) 218 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: ��141 y Residence Tax Map r? 1 • ' ` — 3 Town Y Gentlemen: According to records maintained by the Town, the above noted dwelling 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: nssxssoRS xECOxn:. `i 8D . BFhouseb.�........,,� Slierlila Amler, MD, MS, FAAP Commissioner of Health Robert'Morris,_PE:.,. Director ofEirvirorimentalr ealth Hudson Design 1949 Route 9 Garrison, NY 10524 To Whom It May Concern: Department of Health 1 Geneva Road, Brewster, NY 10509 June 24, 2010 Robert J. Bondi County Executive Re: Addition- A- 088 -10 No Increase in Number of Bedrooms 40 Clubhouse Road (T) Putnam Valley, T.M. # 51- 14 -1 -36 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 June 24, 2010. 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 a royal is for t �. _..... _ .......� , _ ..pp...._.�_. .._ he,Frot�osed:_changes oily: -This apnroyal. does not.va i . ate,any construction shown as existing that has not obtained proper approvals 5. Should the septic tank need to be relocated or replaced, a repair permit needs to be obtained from this Department. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at (845) 808 -1390, ext. 43261. Sincerely, 'V� U), F"� 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 Nursing / Home Care Agency (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 +1 ' 1 . t . f PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY 3 BEDROOMS 4 z4,0c /. /y- x-36 ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE HOUSr PLA�NSS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL SIGNATURE & TITLE DATE A r I PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY 3 BEDROOMS 4 z4,0c /. /y- x-36 ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE HOUSr PLA�NSS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL SIGNATURE & TITLE DATE PRo^ NEW in C'4 al 10' -0,. 33'-61" — — — — — — — — — — — — DKITCHEN BREAKFAST NOOK - HALL C*klTov D TER 9 SF HW_ CAC. E WELL 43 SF 13 SF. PUMP 15 SF tt i. 10' -OR" 6'-64" 15'-Bj" I N-4 9' -6 3'-0j q Ptloolz_ 2'-4j" 2'-10j" 4 CD 0. V) z 0 0 i. in i N i I, a 41, 46'- 1 u, 10' -o j" 36' -1,. I - 0