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Home My WebLink About2514DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. vAmscanyourdocs.com 631- 589 -8100 51.14 -1 -37 BOX 22 ' ir �� ., r -''.� ce J '� y �;; . I, r L , „� , y o T 1 r r - jr, T I ' ;. '. 02514 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OWNER'S NAME L.-. c°_ O Jh a Y �e-;WQ4 PHONE c2 6,6- 7 SITE LOCATION t! 7 n GAO U !� MAILING ADDRESS PERSON INTERVIEWED r , /fir �- Pam Canplaint # Name & Relationship (i.e, owner,tenant, etc.) DATE 1 TYPE FACILITY F �i 6 PROPOSED INSTALLER 15*e- y e K C, _ cJ k PHONE s a� �� d A �'i U REGISTRATION # - 7 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. ropo<e ft �,jel�s W; �lt;h 106 Proposal approved Proposal Disapproved s Sicmature & Title 3 9 roposal 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 canponents tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. 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, or reported agent of owner agree to the above conditions. SIGNATURE c/ TITLE DATE IMS: Wiibe (pC D); YeUcw (fin BI); Pink (k#imnt) L a LORETTA MOLINARI public Health Director ROBERT J. BONDI County Executive 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) ;78- 6085 Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648_ Neiman c/o Jacqueline Lynfield 82 Oscawana Hts. Rd. Putnam Valley, NY 10579 November 5, 2003 Re: Addition — Neiman, 41 Clubhouse Rd. No Increases in Number of Bedrooms (T)Putnam Valley; TM #51.14 -1 -32 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 4, 2003. 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. 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. Very truly yours, Michael Luke ML:hn Public Health Sanitarian cc :BI BRUCE R. FOLE`' wg tia�w�4h�� 0� lb 4�,fb° ; y LO FTTA M41,V ARC z' 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) 278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONL)0 STREET CI"gtKY- P"I TOWN. Pd r9AM ULiTXMAP# 51.1L'I "5-2, NA�1E,6i.CQt ,dll, , _ NONE y6 528 c)06 g PCHD9 A313-03 Ac 'fM '4w Y MAILING ADDRESS DESCRIPTION OF ADDITION R 6LZ9,t°4l+,. 4tA A lcih,vi?A +- Het i • P-m NLNIBER OF EXISTING BEDROOMS ?- PROPOSED # OF BEDROOMS Z (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. lease 'submit this form andithe following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money order for $100.00. s 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 10,15+9 e' BRUCE R FOLEY + Public Health Director LORETPA MOLINARI R.N., NI.S.N_ Associate Public health Director Y Q _ Dlw- -ror of Pact, r.S °¢ D:GPAtcilNtENT OF MALTH -- I Geneva Road Brewster, New York 10S09 Environmental liealth (845)278-6130 Fax(845)278-7921 Nursing Services (945)279-6558 WIC(04S)278-6678 Fa(34S)279-603S Eariy Intervention (845) 278 -6014 Preschool (845) 2786082 Fax(945)278-6649 October 31, 2003 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re., 43 C1;ihb iise Rd. Residence Tax MaP 51 111 -1--37 Town of P- t-nam Valley Gentlemen: According to records maintained by the Town, the above noted dwelling IS NOT ccrnpliance with Town codle and the•tctwl ntirnSa~r of uorr,s on recoil is - This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: BFhousegWdelines Deputy Zoning Inspector �n .i V/ h a /�, KEW a h 1\ ^a Q / �i 5MAY W � � ► I � NCw =d Platform h 1 g 'S \ \ 4 c.•� �1v of CERTIFIED TO /NS!/RANCE COMPANY D /ME � � � SA✓ /.VGS INK Certifications hereon are valid for Bank. .s SURVEYED: JUN45 3' Mato Title Co. 6 Owners for this transaction AUGUST 27 1993 only. Certifications are not transferable to BROUGHT TO DATE subsequent Bank, Title Co. or Owners. BROUGHT TO DATE------ - Ali certifications hera9n are valid for this D(�' (� D (` map and copies thereof only if said map or JOHN . S. •1 ��+i jai 1 • copies bear the impressed seal of the sur- urveyor veyor whose signature appears hereon. Consulting F,'og eit -i '. _. . 1 NQRTj I>SG E "It is hereby certified that this survey was pa�l4►Lt., prepared in accordance with the existing n Coda of Practice for Land Surveys adopted _ 1 by the New York State Association of Pro. r UB \ RGAO t \ i O 11 i N N FoWO bestir on line 0.7'aer SW 1.5' Milt over �xuss M.S.W I = over w � e C W tL 0 v N O> "6 N WoNU1f J 1V 69 oY/ . 1 O' 0. N/F NoRrH V/EW LAKE o - Est-A ?ES BEACH AREA TAX MAP SEC. 51.14, BLK. I , LOT 37 • airy/ ti0 h 46/9O�E 3/3 N. 4uirt, .. / tivT M L / / � Pier Stone Pier_ C coot fCNC<r I/ e Stone Pier 14 ,s•TORY /WANE Food Platform AfL1K � S•v[o � l r /�, KEW a h 1\ ^a Q / �i 5MAY W � � ► I � NCw =d Platform h 1 g 'S \ \ 4 c.•� �1v of CERTIFIED TO /NS!/RANCE COMPANY D /ME � � � SA✓ /.VGS INK Certifications hereon are valid for Bank. .s SURVEYED: JUN45 3' Mato Title Co. 6 Owners for this transaction AUGUST 27 1993 only. Certifications are not transferable to BROUGHT TO DATE subsequent Bank, Title Co. or Owners. BROUGHT TO DATE------ - Ali certifications hera9n are valid for this D(�' (� D (` map and copies thereof only if said map or JOHN . S. •1 ��+i jai 1 • copies bear the impressed seal of the sur- urveyor veyor whose signature appears hereon. Consulting F,'og eit -i '. _. . 1 NQRTj I>SG E "It is hereby certified that this survey was pa�l4►Lt., prepared in accordance with the existing n Coda of Practice for Land Surveys adopted _ 1 by the New York State Association of Pro. r UB \ RGAO t \ i O 11 i N N FoWO bestir on line 0.7'aer SW 1.5' Milt over �xuss M.S.W I = over w � e C W tL 0 v N O> "6 N WoNU1f J 1V SURVEY OF PROPERTY FOR NAROL D I S11E 14A - M CN Rflrz SITUATE IN THE 7"AWN Of �041MIAV VALLEY PUTNAM COUNTY NEW YORK ertAl F_: 1 _ z0' 69 ! -cur 0. o - 3 TAX MAP SEC. 51.14, BLK. I , LOT 37 SURVEY OF PROPERTY FOR NAROL D I S11E 14A - M CN Rflrz SITUATE IN THE 7"AWN Of �041MIAV VALLEY PUTNAM COUNTY NEW YORK ertAl F_: 1 _ z0'