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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51.15 -1 -13 BOX 22 02522 121 IN . : ' 'SIN N - I . . ■, , , 1 I oil MIN or- 02522 f ' III SHERLITA AMLER, MD,'MS, FAAP C_'ommissioner o Health .:.... LORETTA MOLINARI, RN, MSN Associate Commissioner. of Health DEPARTMENT OF HEALTH ROBERT J. BONDI &pijg1l'iFx cutTv &. ROBERT MORRIS, PE Director of Environmental Health I Geneva Road, Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ON STREET %G6 crj 5k1f TOWN PW I/V&Wt V1� Ile, TAX MAP# 1 1J�' NAM1 EtgC kl h-,J 4 1 o n mwe;y1 e,U (orb PHONE P-0- a 6' L°55 PCHD# MAILING ADDRESS �N e 7 DESCRIPTION OF ADDITION t'A)L�r-Ie Sr-CpN P"vck r fi&:4C 4- fm ity A. g1..0itirivr � �,wblww�c�► 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 Dept., l Geneva Rd, " - Brewstc`r,.NY 10509; Phone: -(845) 278 - 6130.' -� .. X. 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 1 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Oscawana Management Corp. c/o Aphrodite Construction Co., Inc. 9 Blueberry Lane Putnam Valley, NY 10579 Dear Mr. Lopez: March 13, 2008 Re: Addition- A- 014 -08 No Increase in Number of Bedrooms 166 North Shore Road, Unit # 1 (T) Putnam Valley, T.M. # 51.15 -1 -13 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 February 20, 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. 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 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, i 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 wAAw rw ^wwAwAAwAwwwAAAAA AAAAwAw w n A w w ' w A A A A A A A AAA•,AAAAAAAAAAw ^// ..A AAwAw ^wwwAAAAAww Aww Aw AAAAw ^w /, //, A w A w A A A w A .. -...• .'!�• .. ell 4 w.rwhA:T^ w' w w A A n AwAA wAw AAnw nww www nA / w w w w A ^AAw A AA •• ..... 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Steinberg "W/1,,,, west /11 /lJ / /, /l e . /e , / /ell /e// //. /,..... /I / / /I / / / / / / / / / / / / / / /I /' ,1 // //e // /// // el, „1JJ,,,JJI / „1, 1, /J/ „lei / /, /, ///lee //1/,,,•••,• /Jl/ p 1e 11.111 /:i / / / / / /J / / /J /J /1 / / / /J /e // D p „//,/,//,//, ,.., / / /J „ / / / /,,,l, / /,,, / „ /,Ablo n , /,J / / / / / / / / / / /L // / // /, / / //. /,l /111 / /, / / / / / / / / / / /, / / / / / / / / / / /// /Jell. /, '//// e/,el JJ11. Jl /11J1JJ,111,leJ ....• /,111 ,J //lire,!! /l/l,l,ll//1Jll,llJJl. ./,// „//e //le, l/// / ;ae5a Sou NORTH SHORE ROAD �1 ti ROAD TAKING, 1.INE•9. PER''FII,ED':MAP -*A1, • dc• IIBER;'232�`i?A��s`29 �,.:: �,.�:`,.; :�` :, �v � �., � ,. v ti• Y 1, _..� .a W 30'38`07,:. 5 •107.86' � N 6 v r N /F FRAMED (F HENRY J. & DWELLING � .FRAMED° . 2c�h p,'09 •: DWELLING EMILY M. MARTINEZ 6 ~ LIBER 1017 PAGE 279 : FRAMED "'DWELLING 8.45 ACRES m DWELLING ! t�. Z FRAMED.- ZS FRAMED DWELLING'; T.<� DWELLING gS4;,r .� I.PIFi_ FRAMED ��JR 6 FO' ' DWELLING N F DOUGLAS & FRAMED ELINOR KRIEGEi I OF (0 TOWER DWELLING 0" LIBER 732 PAGE fp /, FRAMED 4 ALLEY ,Z� OVJELL Q/, DWELLING FRAIMED GE 261 1� - -- Di ELLING // • i PINE t7 HOLLOW t•.. ,/ ROADF, :PIPE FOUND �� ` :�... FRAMED _ ... I FRAMED \�• j v DWELLING DWELLING �\ FRAMED N 13'35'36' E I DWELLING o L I LU 77.00 - K1111111J yo '' c ; `t CL n o N 29.07'56' E ELL a J :`67,63' QV /( BUILDING ENCROACHMENT N/F .AMERICAN STATEGIC •��� • - LROD N 10� J INCOME ' PORTMOLIO, .It4C. Phi !' , LIBER 439 PAGE. 91 FOUND ?65,i 9. , SHED. N 12'46'19" W 156.73' LPIFE FOLIFIC, S 88'52'21'••W > : :: PRIVATE .ROADWAY JOHN:N /F ... w • V:: JULIANO JR. c LIBER ' 1101." PAGE 242 I s / N Noce -� S k c: ' (d• �� Cn0�� fr i : �,$.zIJFRI,IT.A 1M[1.ER, MD, IVIS;, AAf - Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ..ROBERT-J:...BONDI -- County Town Legal Bedroom Count OSCAWANA MANAGEMENT CORP-. Re: SOi1ZA (Owner's Name) Tax Map #: 51 -15-1 -13 Address: (166 North Shore Road) 1 Goer r-TGl �e ail Town: P„ t-n am * Va I I..3r Year Built: 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: This information has been obtained from: Certificate of Occupancy: Other: R „i� �; ng�Recarris wilding Inspe ` 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 Early Intervention /Preschool(845)278 -6014 Fax (845) 278 -6648 Uu JOB ARROW EXCAVATING, INC. SHEET NO. [ /NITS Dy 4- ei OF 01' ✓OW*IC!y+� , r:.. - L rJ3 3 _ .. _.. ..... CALCULATED BY �C1�4 Is7� .ZL! DATE 7 CdJJ aim (845) 227 - 4505 ('914) 528 -4395 CHECKEDBY�Let�c�� DATE -&=-5--6W J 8 AS gu; Ik JOB ARROW EXCAVATING, ffI))N,�C,�., SHEETNO. U,IZZ -5 V172- OFQ���` L�� �Y'126 - - �p CALCULATED BY_({j �1FCr.. w DATE CHECKED BY /iJl rl �� {� d"G IF b DATE 1 _ SCALE Putnam County Department of Health Division of Environmental Health Services 0A, i S SSTS Repair — Final Site Inspection Date:. 13 (� (iIInspectedby: L Installer: Arroc-4 C, Street T i% do • 6` KboL, Ste'¢ kA n.0 OS r 0'-1Aa1 Lk jworkf _ 1. Type of System: Conventional 19 Alternate[] Comments: I'C' t' 2. Se tic Tank Yes No -N /A Comments a. Septic tank size -1,000 ... 1,250... other ..... b. Septic tank installed level ...................... c. 10' minimum from foundation .................. d. Distribution Box i. All outlets at same elevation (water tested) ... ii. Protected below frost ............................. iii. Minimum 2 ft. Original soil between box & trenches e. Junction Box — properly set ........................... f Trenches i. System completely opened for inspection ii. Length required Length installed iii. Pipe slope checked ... ............................... iv. Installed according to plan ..................... V. 10 & fr om property line — 20 ft — foundations ... vi. Size of gravel' /, - 1 %: " diameter clean ......... vii. Depth of gravel in trench 12" minimum ......... Ends ca d . g. Pump or Dosed Systems 3. Sewa e System Area a. SSTS Area located as per approved plans b. Fill section — c. Distance from water coursetwetlands Vr 4. Overall Workmanship a. Boxes properly grouted and installed correctly ........... b.. All pipes flush with inside of box ......................... c. Backfill material contains stones <4" diameter ......... d. Curtain drain & standpipes installed according to plan e. Curtain drain outfall protected & dir to exist watercourse f. Footing drains discharge away from SSTS area ......... g. Erosion control provided ............................ Additional Comments: —pie, ex•"Jl 40tt'k (0CCJi*PA, RFSI Rev - 011312 A), S�e Putnam County Department of Health Division of Environmental Health Services SSTS Repair — Final Site Inspection Date: (I Inspected by: MO Installer: ro W Street Location: 10 L n S Owner: U5CO.,.%14. Faif Tor rut 1. Type of System: Conventional ❑ Alternate [Comments: IT 2. Sevtic Tank yes No N/A. Comments a. Septic tank size ,099 J.. 1,250 ... other ..... b. Septic tank installed level ...................... c. 10' minimum from foundation .................. d. Disiribution Box i. All outlets at same elevation (water tested) ... ii. Protected below frost ......... ................... ✓ iii. Minimum 2 R. Original soil between box & trenches V1 e. Junction Box — properly set ........................... f, Trenches i. System r2m ._pletely Mened for inspection ✓ ii. Length required 1VIA Length installed 14 �- f r.S iii. Pipe slope checked .................................. iv. Installed according to plan ....... ............. v. 10 ft. from property line — 20 ft — foundations vi. Size of gravel % - 1 1/2 " diameter clean ......... V111, vii. Depth of gravel in trench 12" minimum ......... viii. Ends c ed .... ............................... R. Pumn or Dosed Systems 3. Sewap-e System Area v7_ a. SSTS Area located as per approved plans b. Fill section — c. Distance from water course/wetlands ✓ 4. Overall Workmanship ✓ a. Boxes properly grouted and installed correctly ............ b. - All pipes flush with inside of box ......................... c. Backfill material contains stones <4" diameter ......... d. Curtain drain & standpipes installed according to plan e. Curtain drain outfall protected & dir to exist watercourse f. Footing drains discharge away from SSTS area ......... g. Erosion control provided ............................ Additional Comments: P.FS1 Rev - 011312 { 6G d' 5 va, cr- k � Putnam County Department of Health Division of Environmental Health Services SSTS Repair — Final Site Inspection Date: (I Uv� Inspected by: &A b L I- Installer: r —r-P c--jex-c- Street Location: . ILI t tn, dat S Owner: O cc, WAr"k if- V 3- To -m 4 1. Type of System: Conventional WAlternate ❑ Comments: /(,. . . kk At P ceAr, e-.(\ 2. Se tic Tank Yes No N/A Comments a. Septic tank size —1,000 ... 1,250 ... other ..... b. Septic tank installed level ...................... c. 10'minimum from foundation .................. d. Distribution Box i. All outlets at same elevation (water tested) ... ii. Protected below frost ............................. iii. Minimum 2 ft. Original soil between box & trenches e. Junction Box — properly set ........................... f Trenches i. System completely opened for inspection ii. Length required _ Length installed iii. Tipe slope checked .................................. iv. Installed according to plan ....... ............. v. 10 ft. from property line — 20 ft — foundations ... vi. Size of gravel 1/4 - 1 1/2 " diameter clean ......... vii. Depth of gravel in trench 12" minimum ......... viii: Ends ed ................................... g. Pumv or Dosed Systems 3. Sewaae System Area a. SSTS Area located as per approved. plans b. Fill section— : c. Distance from water course/wetlands 4. Overall Workmanship a. Boxes properly grouted and installed correctly ........... b.. All pipes flush with inside of box .......................... c. Backfill material contains stones <4" diameter ......... d. Curtain drain & standpipes installed according to plan e. Curtain drain outfall protected & dir to exist watercourse f Footing drains discharge away from SSTS area ......... ---7L g. Erosion control provided ............................. Additional Comments: RFSI Rev - 011312 PUTNAM COUNTY HEALTH DEPARTMENT 0 DIVISION OF ENVIRONMENTAL HEALTH SERVICES FflCtiSEWAGE- TRT( dTS1 (STEMI'REPA°rFi'i_.- _, -.-.� : -.. a'Z 2L' YES KRZ Internal Use Only PERwr # , ❑ 9 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 /�� (/o Al TOWN I,�. TM OWNER'S NAME ¢- kose,,.itj PHONE # MAILING ADDRESS /.S eQdAllf CIA an APPLICANT Name & Relationship (i.e., owner, tenant, at&rad DATE /r�— %— 201 3 FACILITY TYPE S ®S PCHD COMPLAINT # e✓E3 PROPOSED INSTALLER Agezoll �C, _r, C PHONE # ADDRESS 11/3 REGISTRATION /LICENSE # �/Ol 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 system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair. It /J[i L� ✓ s9�`, (Ecr�f..•r� � 4 � ! - Ucc/ Xje w --.S Y I, as owner,agree to the conditions stated on this form SIGNATURE �-vs TITLE ,v W DATE 11-2 LG I� (owner) I, the septic Installer, agree to com ly with the conditions of this permit for th ptic system repair SIGNATURE TITLE (installer) Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfill until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Pro osal d rxr Pr pospJ Denied ❑ Atf �-��� 9 I 1 2 13 l l 1 Inspe or's SigrTature & Title Date Expiration Date Repair proposal is in compliance with applicable codes Yes GV No O COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES ' P-ROPOSAI.- FOR.SEI AC-sEF TPi EA T "�ENT.SYSTEtwi.:RF;PA- IR...._. YES NO Internal Use Only PERMIT # -.L:L U ' .J ?)._., ❑ 19 Repair Permit issued in last 5 years Not in Watershed ❑ 0 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 V. TOWN _ TM OWNER'S NAME /�SLcL� si z� , nf;,n�,r�jia < PHONE # MAILING ADDRESS e 9 ,�G' i_ /�/s T Z/ "L?� P_ �,� ��s d h APPLICANT Name & Relationship (i.e., owner, tenant, contractor) DATE //- L/. `Zyt: FACILITY TYPE S"� S PCHD COMPLAINT # PROPOSED INSTALLER ��� C, ..%t ! PHONE # �S-'C� Z °)OC ADDRESS u/l /.fir �,`JXV /r7rJ'lS,�1( REGISTRATION /LICENSE # Zell 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 system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair. 4V Ile I, as owner,agree to the conditions stated on this form SIGNATURE y, TITLE ysi.ti� 4550 -C. DATE (owner) __...__1,Alreseptioinstalher, agree to comply with the ciiiuitiais- ol•this :perrnii forthe septic system repair" SIGNATURE TITLE ,f. < DATE (installer) Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfill until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Prop al Approved Proposal Denied ❑ Z Ins ctor's Si nature & Title Date Expir io Oa (e epair proposal is in compliance with applicable codes Yes No ❑ COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 PUTNAM COUNTY HEALTH DEPARTMENT �+ DIVISION OF ENVIRONMENTAL HEALTH SERVICES CROP.. AL-.-F.QR --SE AS EI -,T-RE-AT'HRE-0,T:,.SYS I _- PAIR.u_�..-:_. ,.._a.: _...�. YES NO Internal Use Only PERMIT ❑ IP, Repair Permit issued in last 5 years Z Not in Watershed ❑ 0 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 *V &,-1 g�/% TOWN ._ e , TM #,-52— 3 OWNER'S NAMEC.�z/of�rt//� �%Jt'��?,/'A� S PHONE # MAILING ADDRESS AL. e�� APPLICANT evvlw6 cdcil4Lzv Name & Relationship (i.e., owner, ten '., contractor DATE XG /t! ! FACILITY TYPE ��e j PCHD COMPLAINT # 4'0 PROPOSED INSTALLER ¢ r. PHONE # EX 6<2 9 2k ADDRESS REGISTRATION /LICENSE # 67 Prog_osal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair. ar jw i I— dIA I, as owner,agree to the conditions stated on is form 1 SIGNATURE .� �d TITLE �°'�2 +' j�5�`� DATE - _(owner) - -I -, the- septieInstailer, agree to comply with the Conditions'of this permit'forthe septic'system repair . SIGNATURE TITLE DATE / /3 (installer) Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfilled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved Proposal Denied ❑ goDaIns ector's Signature & Title dyl� Date xpir e Repair proposal is in compliance with applicable codes Yes No ❑ COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 I JOB ARROW EXCAVATING, INC. SHEETNO. 2-13 ZAK S'Zil✓ -. OF ial/ 15 AVALON COURT zz: --1 �f- HOPEWELL -XIT_, NY..12533 . _CALCULATEDBYT �-� �/ DATE ._... r:_,....: �.. _,��'•�_ ._ ..: ,,... _......a......N.� ., CHECKED BY`[ T DATE SCALE SHERLITPAMLER, MD, MS, FAAP • - - ..••."�'r.r71..— ..rSd..•Y'.°.," Of <� ?fll.r, -. .., - LORETTA MOLINARI, RN, MSN Associate Commissioner. of Health DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 ROBERT J. BONDI ROBERT MORRIS, PE Director of Environmental Health ADDITION APPLICATION RESIDENTIAL, ONLY STREET 46 Ni t A T ®vvN w 1/ f` TAX MAP # -f-t lj'*!- 1,1,3 NAME Ri e4J#,J /At-,uW' "ea� �r _PHONE f folio- 3� � ° �. PCHD# MAILING /ro�� ADDRESS 9 U 6y e 6 e,L9 Z-4we,, /''�r �n/.a -ter AIle / 057.F DESCRIPTION OF ADDITION .4JJ atil S' -ree�JeJ ti�c.A 40d 641e� v-34:P4,,o,m 14 ij &kb 1 NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS 3 (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 -7 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 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 Oscawana Management Corp. c/o Aphrodite Construction Co., Inc. 9 Blueberry Lane Putnam Valley, NY 10579 To Whom It May Concern: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health February 13, 2008 Re: Addition — Application Incomplete — A- 013 -08 166 N. Shore Road —10 Country Club Road (T) Putnam Valley, T.M. # 51.15 -1 -13 Review of plans andother supporting docuinerits suumitted"at `'this-iinre�reiative.-to -the abevc,.. -- a - - regarded project has been completed. The following was not submitted with your application: 1. Copy of survey showing septic locations to the best of your knowledge. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. LCW:kIy cc: Sincerely, Lawrence C. Werper Public Health Engineer 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 P SHERLITA AMLER, MD, MS, FAAP Commissioner o� tlealtli '� _ " LORETTA MOLINARI, RN, MSN Associate Commissioner of Health. _ ROBERT L BONDI . - s ... C:ourity Bzecui& . , . DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count OSCAWANA MANAGEMENT CORP. Re: BREZNAY (Owner's Name) Tax Map #: Address: (lhh Ncirth_ Shoxe Road) -= 10 Coon y Club Road Town: Putn..am Valley Year Built: 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: 3 This information has been obtained from: Certificate of Occupancy: Other: Building Records -v 613ui ding Inspector I 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 .ROAD TAKING, 1,INE `•, ' PEh fi ED-:MAR;a�loti3; ' dc• IIBER`'232}��?A��'•�29'��� �;,.;;- �;: +•::.± �v , `v .;� , �N ..: 107.86' N Cp. C rr N /F FRAMED, � HENRY J. & DWELLING FRAMEO;_: � � M. 6.�k'�9 aWEIEI ?JG' �. LBERY1017M PACE N279 a 15 'DWELLING 2� 8.45 ACRES DWELLiNc FRAMED 2S FRAMED DWELLING DWELLING qSo .� .l I,Pitf: FRAMED u hq�l R ,Q DWELLING °qo 6 N/F , ; t � ='�� 'Z' 1� DOUGLAS & 6`�i• L 3 r` r 7 FRAMED :.1�' ELINOR KRIECEI IF e aa,, TOWER DWELLING ; �' 0, LIB ER 732 SAGE f ` V FRAMCD� y'% 5 EY °� SWELL pi, DWELLI 261 S� L 1 FRAI.1ED . X3`1 ' DWELLING ; 'INE ZOAD FOUND '. _ ...... L.FRAMED �. �.0. DWELLING DWELLING FRAMED' ; i DWELLING a uj N 13'35'36' E Cf y 4 I 77.00 ' z . tl O Q N 29'07'56" E Z.O —`WELL 1 J...: 67,63' BUILDING `� J /NG ENCROACHMENT .N /F AMERICAN STATEGIC \ •�� LROD N 0' \ INCOME ' POR TTM OLIO, - .I14C. ohr� FOUND ? J9 • ` UBER 439 PAGE. 91 6510/ ,��SHED N 12'46'19" W 156,73' (.PIPE: FOUt;[ S 88'52'21" •W z , : :: P R IVA:TE 1 oo,op' :.�:::RO•ADWAY JOHN V:: JULIANO JR.' f LIBER 1101•',PAGE 242 Iv+ S CA Cu /f /U A SHERLITA AMLER, MD, MS, FAAP Commissioner of Health ...._ - °' LiiiiEl ya�l"vi�liriNi�r7i;Rl+T,'Ni�N` ' - -' - _ •- Associate Commissioner of Health February 28, 2008 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Oscawana Management Corp. -c /o Aphrodite Construction Co., Inc. 9 Blueberry Lane Putnam Valley, NY 10579 To Whom It May Concern: ROBERT J. BONDI County Executive .ROBERT MORRIS, PE Director of Environmental Health Re: Addition — Approval — Oscawana Mang. Corp., A- 013 -08 No Increases in Number of Bedrooms 166 N. Shore Road, 10 Country Club Lane (T) Putnam Valley, TM # 51.15 -1 -13 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 February 28, 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 .m wir�talncd: 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 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. Sincerely, Lawrence C. Werper Public Health Engineer LCW:kly cc: BI (T) PV 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 BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 LORETTA MOLINARI RN., 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 October 23, 2002 Sue Kurian 4 Villone Dr. Leeds, Ma 01053 Re:Addition - Kurian -19 Country Club Lane No Increases in Number of Bedrooms (T) Putnam Valley Tax # 51.15 -1 -13 Dear Ms. Kurian: 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 October 22, 2002 The addition is approved with the following conditions. 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. 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 Valllev. If you have any questions, please contact me at your convenience. Very truly Y, urs, Michael Luke Public Health Technician ML: cc:BI DCT -6 -2002 12:33 FROM:PUTNAM COUNTY DEPART @45-276 -7921 anct R. FOLEY Public #ealth Director TO:919147396736 P:1 /2 LORMA MOLINARI RAT,, A .S.N. Assoclats Public Xealth Director Director of Patfew Services DEPAR'TMEM OF HEALTH 1 Geneva Road Brewster, New York 10509 Envlroainental Eiewlth (845)279-6130 Fax (94S) 278.7431 , Nursing Servlca (845) 278 -6558 %VIC (84S) 279 - 6678 Fa (845) 27B - 6085 Early rnterventlon (445)278-6014 Ymscheal (645) 278 -6082 Fax (845) 278 - 6649 . AWZION AWLICAMON ESgD_�TTI�L ONLY) �� TREEI' CA, N� TOWN WS�x -NAM6�L���JH PCE* MAILING ADDRESS L,.N,ve P/1- G ��' .9 oz P .573 DESCRIPTION OF ADDMON ,a b. a=" S� (? i� i n NUMBER OF EXISTING BEDROOMS C. PItOP,OS1rD # OF BEDROOMS ( FFROM C&RT. OF OCCUPANCY OR • : ' ' . CERT1fICATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal app= of-;I= (Constructionpermit) prepared by a Professional Engineer or Registered Architect in accordance with applicable 'sections of the Putnam County Sanitary Cods. :.. _ P1 5 sbszllttbus:forn�' and.ihe.foilocving to PUtnarri Co UtxHealth Dept., 4 G mcva Road, Dret+vsier; N1r ' 10509, Phone 279 -6130. f� 1. Certified check or money order for 3100,00.. 2. Sketches of misting floor plan (drawn to stale, all living area including basement) *Non-professional sketches are acceptable. 3. Two secs of proposed floor plan (drawn to scale, with name, street, and tax map # i. *'Non- professional sketches are acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of is installation if known. Label all wells and septic systems within 200 fact 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. SCE USE Comments i ' Feb98 BFhouaeguidetinea OCT -8 -2002 12:33 FROM :PUTNAM COUNTY DEPART 845 -278 -7921 e � 1 r, 13RUCE fi. FOLLY TO: 919147396 (.Sb 4 LOU=A MOUNAit AsiwiW PHbbe Aealrb Dfiu W 1}trectar of Padew Se"A" bEPARTMIM OF HEALTH I Geneva Road Brewster, New York 10509 ; Baniroanaftl Wd1h W278-6130 Fox (W) 178 - 7921 NawiaB owdea (845) 178 - 6559, wM (84S)278.6670 Fax (845) 378 - 6085 Early ant "Orlon (841) 278 - 6014 Ptwlieel (845) 27&M2 . Fat (649) 178 - (648 Putnam County Dept. of Health' 4 Ocneva Road )Brewster, NY 10509 Residence Tax Man- Town L �t• Gentlemen: According to records maintained by the Town, the above noted dwelling ' A NOT , to compliance with Town code and the total number of bedrooms on record is This information has been obtained from: CERTMCATE OF OCCUPANCY: ASSESSORS RECORD: OTBER _ 1 Building Inspector BFhouseguidelines o_y) ••� dC• U9ERt=2'i'.i$•: ;^'►:;ZJ ' r_ ; ' 1...._,}iry:v: t!y } �� •ae k �, • � .1'... }�'S 30'38'07" WW"f0i •107.86 FKAMEO •.. N /F 4' ` .DWELLING. . HENRY J. & FRAMED.' DWELLING EMILY M. Mt4RTINEZ S Y... \ USER 1017 PAGE 279 . i 0� ,�:� . ' � � -:'FRAMED _ � f• ` �� �` - . �''� ® • 3 :DWELLING RE a� FRAMED-- FRAMED DWELLING • } DWELLING o DWELLING "z d Fcu: N : F . DOUGLAS ..: f/F FRAMED agkk - :�ELINOR KRIE OWN:OF. fo P,TO ER DWELLING '` ® UBER• 732 ;PEA( FRAMED I PAGE. DWELLING cA r� . . e' / p e I.. ,i a a� FRAMED �� [[ % DWELLING LLB, r� �° • CIF,. `. ,PIPE _ ..... FOUND y'"?k . .�... ,•� -y FRAMED FRA►nEG '� DWELLING t� I t DWELLING , FRAME`B-_ N 13 3536° - - -- LL N E i r; t 1 tG DWE I u ' w' _ -�0• » - - i o G t cr N ? �` rurl.© Vvv 7'56" E WELL "\.s q I� U.J. \ :.67.63' VI( BUILDING 0� ENCROACHMENT �`�� AMERIICAN- STATEGIC 1 I.ROD �O• V I COME'. PORTFOLIO..INC. o FOUND `�7:T I V UBER 439 PAGE- 91 " ?�S 9° SHfO. ,Q. �.. N 12'4 1561.73' 9" W V - _� � LPIFE •� ' . S 88'52.21e ••W ' PR6VATE 190.0 AY NSF.. W JOHN •V.:- JUUAIdO JR. lc, LI.BER_ 1101 :' P.AGE 242 u+ r JUN -28 -2004 09:00 FROM MR ROOTER PLUMBING TO 2787921 P.02 P :l.'1'I`�r.A -. T.q;D AF.T.NMMJ' -. _ � .,. DIVISION OF ENVIRON1ViENTAI. HEALTH SERVICES SITE LOCATION 03C4W A AJA C4,'-OA- OWNER'S NAME A1XQ l/ A-C,60AJ._ MAILING ADDRESS 16 G AICArA54#09 oFFiC1Ax. USE ONLY . a a yam, , 51. /'6- - I I_ PHONE 91-1 �- IrAloftj _ Al • Y. /I PERSON INTERVIEWED tens�t'�aT- DATE lv� o TYPE FACILITY _.- _ -_ -- PROPOSED 1NSTALLER /Pl _ &o ilea Al V IYA yM� PHONE �5 b 3 y� 4ib Z. ADDRESS /7�Ci �'°' 80 �Z"AAR- YAa-fY 0 REGISTRATION # -- EMNW (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as ortgiaal sewage.disposal system .Different location may require submittal of proposal from licensed professional..engineer or registered architect. I, as owner, or agent of owner agree to the conditions stated on this form. SiCrNATURE +Ei 'l - 1, el' A* le �C DATE- with the follo 'ag sjwditions:. 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name b. Site Stt'eat 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 diatn. X 6 deep e. Installers' name and number. 3. System repair to be performed in accordance with the above proposal and conditions. Proposal approved- -� Inspector's Signature 8t Title /DATE// COPIES: White (PCHD); Yellow (Town 100, Pink (applicant), PC -RP 99ML TI IA I ^in -nnn n —, 13 JUN-28-2004 09:00 FROM MR ROOTER PLUMBING RS TO 2797921 P.01 PLUMBING To: 7iz co V "i From,81 Date r-<1-6 .-RE: Fax To # Z 7 7 V. Fax Froinn: (845) 635-1173 Voice: (84'.S), 635-2102 Number of Page; S'(Includlhg Cover-Sheet): 'Message: AP, S Li s Uj 4AJ OL, c 4,e t A-1 vAA 1/d-l-lrr Via { 10 High Cap. Infiltrators 40 ft Oft 4 hole Box!) 110ft Oscawana mgt. corp. 6F7 20 country club fa n oscawana lake putnam valley Permit R -22 - 4 Tax Map 51.M-1-13 Approval Date 6.30.04 As Built f� 121,29/2004 14:34 8456359802 CEC -r9 -2004 10:27 FROM!PUTNAM COUNTY DEPART 645- a78.7 %j P PAGE 03 70:9635980? P14 -14 ' ► • • ENMONNEMAL : a. ,�. . gra LOCH 0SIM'S ,t�te�ILDvQ PER80N RMR'VWV&D PCHD Complaint 0 DA'Z'E_ PR,OPOSEU JNSTAY.LER i'i;C>rTE 215 ls3S =� ADDRES3114 27 W��ta�ovfi 1ti� QM XMSTRAIWX# &mil (Lnelhdo sketch locaft all adJacom wale): NOTE: Repair moot -be to same Watkm ad of mpa;s type as wWW WNW dig=W a3j►ft m .DWomnt location may rAWre s0mittal of propoael fmmi UcovW profusional onooar car ad 4mhitwL I . ft"ftmm of aq Town pamit, if gplicable, 2. SubWuton of as built repair aim* 14 duplicm showing: a ..OWJd+ef'>t OmttC b. Sim Stmoet Noma, Town and Tax Map m mbar. C. Location of i>osstal W a *mponaris tiled to two And pohtts04,10m oomm). d. s a>Iraaiptioa (e.g.,12SO . C >aepda tenlc, �baroe pa�gcwet d' . X-& deep e.astrAllwe' rasme cad mbar. 1. Sygoem m*r to be p domon Jn aacotdm m with the above. proposal and wnftons. lopector's Slpmbnc & Title COPIES; whko (I dox Yonfo* ('Town no: Pke (sppt+w PC-RP "ML - c 2 c DA nC*r- �c -nrAM4 I:IFn 14: P.7 TFI_: 845- 278 -7921 NAME: PUTNAM COUNTY DEPARTMENT OF P. 3 1. If \I.Ar . nl ITk InM i ^ill IA IT \J i"�rl"Ir1I:1TMCA IT f'1C C C rJ T .J Q nrr^_�o_�tafad LlCn 14,P4 TR : R4S - ?7R -7401 M1 r�r • V `n1 w NAME:P:ITNAM COUNTY DEPARTMENT OF P. 4 CS c�MC-6 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL-HEALTH SERVICES. OFFICLAL USE ONLY SITE LOCATION ()SCataa\oa �� C.,�Ab TM# ✓�� 3 _ OWNER'S NAME be-o a PHONE I $ 4b1 MAILING ADDRESS 25 - 2b CckacN 1r \\a s � PERSON INTERVIEWED PCHD Complaint # ame & Relations hip (i.e., owner, tenant, etc. DATE TYPE FACILITY PROPOSED INSTALLER L..M �� P� n �2 �ea�a a PHONES, (6135-9 ADDRESS NYI Rk. LAtI OW-AA7 SILS l W %2569 REGISTRATION# 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. I, as owner 1114 repo d agent o owner agree to the conditions stated on this form. SIGNATURE TITL9'Y �- L¢ 4 DATE —t 3 J D q 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.,house corners). 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 performed in accordance with the above proposal and conditions. Proposal approved Inspector's Signature & Title COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99M L DATE SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Ablon/Piver 245 West 25t" St. NY, NY 10011 DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 Dear Mr. Ablon & Ms. Piver: ROBERT J. BONDI County Executive January 18, 2005 Re: Addition — Ablon/Piver, North Shore Dr. No Increases in Number of Bedrooms (T) Putnam Valley, TM #51.15 -1 -13 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 January 14, 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. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. 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. ML: lm cc: BI (T) Putnam Valley Sincerely, Michael Luke. Public Health Sanitarian 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 %C t,ry 6 �> 'D r-, le A A-e-4 �I 6, - „JL we�y t s I, m, n± w' 6 m L9 0 tJ! � :! O O ti m a S! C: N W t m, S 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 C ' Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 60 (� Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLYI STREETO� �ShOr� �ff_IV(TOWN I�'l TX MAP# SI.O a S NAME (l I V —r PHONE S -A PCHD # d-'0q-.05 MAILING ADDRESS o? I,UQS� QY ) MY L U I DESCRIPTION OF ADDITION Ll V 1 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.approyal of plans_(Construction' Permit) prepared by a Professicnal Engimeer ct 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 10509, Phone 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) * 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 Comments : ' A r,! r LORETTA MOLINARI Public Health Director 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/Preschool (845) 278 - 6014 Fax (845)278 - 6648 Putnam County Dept. of Health 1 Geneva Road Brewster, NY 10509 To Whom It May Concern: ROBERT J. BONDI County Executive 6'.t 'e 'r .- R Tax Map S Town , According to r ords 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: houseguidelines J �°�Wlding Inspector Xt' 21 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Leon Ablon/Dixie Piver 245 West 251, St. NY, NY 10011 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re Dear Mr. Ablon & Ms. Piver: ROBERT J. BONDI County Executive January 12, 2005 Addition — Ablon/Piver, North Shore Dr. (T)Putnam Valley, TM #51.15 -1 -13 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. The septic system location was not shown on the survey. 2. The study is considered a potential bedroom. 3. The legal bedroom count for the dwelling is two. The potential bedroom count of your proposed addition is three. 4. The addition of a potential bedroom requires this Department's approval of a revised �.. septic sy stern pla*: frcr., a ;prb fP��i� n2l:en i-�.eer Please revise the proposed floor plan to reflect no more than two potential bedrooms, or have a professional engineer or registered architect design a sub - surface sewage treatment system meeting present code requirements. If you have any questions, please contact me at your convenience. ML: lm cc: Aphrodite Const. Co. Sincerely, Michael Luke Public Health Sanitarian 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 / CRONIN 39 Arlo Lane Cortlandt Manor, NY 10567 Professional Engineering &Consulting T: (914) 736 -3664 F: (914) 736 -3693 LETTER OF TRANSMITTAL April 28, 2016 Mr. Joseph Paravati, P. E. Assistant Public Health Engineer Putnam County Department of Health 1 Geneva Road Brewster, New York 10509 Re: Oscawana Country Club - Septic Repair R- 179 -15 Clubhouse Road Town of Putnam Valley, New York These are submitted as checked below: 13 For approval ❑ For your use []As requested ❑ For review and comment ❑ Please Reply Sent via hand delivery 04 -29 -16 Please find enclosed the following information for the Wetland Permit Waiver Application for CYO's road maintenance plan: 1. 3 copies of the As -Built Subsurface Sewage Treatment System. 2. Original Electrical Underwriters Certificate. Should you. have any questions or require additional information, please contact me at the above number. Thank you for your time and assistance in this matter. Signed: Keith C. Staudohar, CPESC, CPSWQ Copy to... Baraba D'Elia, OMC File Pcdh- paravati -occ ssts as built 4ransmittal- ks- 20160428.doc Cronin Engineering, P.E., P.C. STATEWIDE INSPECTION SERVICES Service With /ntegrity State Wide Inspection Services 21 Old Main Street Fishkill, NY 12524 845 202 -7224 Phone 914 - 219 -1062 Fax Email: officeCa swisny.com Website: www.swisny.com BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES CERTIFIES THAT: Upon the application of: Taylor Electric Box 145 Route 22 Croton Falls, NY 10519 Upon premises owned by: Oscawana Management Corp 166 North Shore Road Putnam Valley, NY 10579 Located at: 166 North Shore Road Putnam Valley, NY 10579 Certificate Number: 2016 -3504 Electrical Permit Number: 355 - 1603. , Section: 51.15 Block: 1 Lot: 13 BDC:-808 Building Permit Number,, A visual inspection of the electrical system was conducted at the Residential occupancy described below. The electrical system consisting of electrical devices and wiring Is; located in /on the premises at: 166 North Shore Road Putnam: Valley, NY 10579 The Outside Basement and First Floor were inspected in:accordarice with the NYS and i FPA -7G -1008- and the detail of the installation, as set forth below, was found to be in compliance on the 411 day of April 2016. Name Quantity Rating Circuit Type., Pump 01 Alarm 01 Switches 02 2610 Officer: Frank J. Farina This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. This certificate is valid for work performed before date of inspection only. �Lt 4;s/ PUTNAM COUNTY HEALTH DEPARTMENT J DIVISION OF ENVIRONMENTAL HEALTH SERVICES SEro��� T� ��E��� �`YSTE��= �EP�R PROPOSAL f0k V NO Internal Use Only PERMIT 8,R-1 " I ❑ U Repair Permit issued in last 5 years Not in Watershed ❑ Q Repair within Boyd's Comers, W. Branch or Croton Falls Res. ❑ Delegated ❑ ❑ Repair within 200 ft. of a watercourse or DEC- maDDed wetland ❑ Joint Review SITE LOCATION (&y (; Fp, TOWN PurpJAIm lkdlol TAN # 51.19 - BI° 13 OWNER'S NAME 05(A ~ ~Mg- PHONE # �' Z MAILING ADDRESS ) gA,f !77,1 TW 5T, �Jt':W\I OILY b2l I o 6-19 APPLICANT 0 Name & Relationship (i.e., owner, tenant, contractor) DATE 101 8 �r _ FACILITY TYPE lq AM44i PCHD COMPLAINT # PROPOSED INSTALLER am -Mms � =&MOUA PHONE # Cl L!± - ,*03 • ° ADDRESS 'F WOK 7 , � � ®�- W\4 REGISTRATION /LICENSE V af; r3-sy L � Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200 loot of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nahiro anti axtant of tha renair I, as owner,agree t elpitift9lt s 18A PC 39 Arlo Lane SIGNATURE E eXAI DATE 19 Itki I, the septic inst ler, agree to co ly with the conditions of this permit for the septic system repair SIGNATUR LE f DATE (installer) Proposal approved with th ollowing conditions: 1. Procurement of any Town Permit, 0 applicable. 2.- Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfilled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved Proposal Denied ❑ /& 7eoes d Signature & Title / ,�q Date -Ex— Yion ate ( I air proposal is in compliance with applicable codes Yes ❑ No COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAIR YES .:..:, NtD.. _. .: - .......: _ Iriiernai "Use only :.._ NERM ff *A � ► ....'.�?.:: . ❑ 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 (�QQf,JfjLJ 6WJ; "p TOWN y TM # OWNER'S NAME Q MA, 44e-Met T' PHONE # —n?- MAILING ADDRESS U1 L✓^ � -14ITd Ir Nt:-U-,y DI4- N� (9 075 APPLICANT �} Name & Relationship (i.e., owner, tenant, contractor) DATE 01 D FACILITY TYPE i_ PCHD COMPLAINT # PROPOSED INSTALLER PHONE # ADDRESS REGISTRATION /LICENSE # Pro°osal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depending on the nature and extent of the repair. lZ:' � 71 n.,t o ¢v e-zaWt0 t—/AXEIKnamIx4 Fe Pe- ..I *T=-0 I I, as owner,agree tP4poi t�iRid'r1gIneedmi; BE) PC 39 Arlo Lane _ SIGNATURE rtinnd# Manoi; NY 1n5T0 -E C1� -6I% '� DATE l< towner) I, the septic installer, agree to comply with the conditions of this permit for the septic system repair ~ SIGNATURE onstaller) Proposal approved with the following conditions: 1. Procurement of any Town Permit, if applicable. 2: Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfilled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved ❑ Proposal Denied ❑ Inspector's Signature & Title Date Expiration Date Repair propo sal is in compliance with applicable codes Yes 0 No O COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 a ALLEN BEALS, M.D., J.D. Commissioner of Health Director of Environmental Health November 13, 2015 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Cronin Engineering Keith Staudohar 39 Arlo Lane Cortlandt Manor, NY 10567 Dear Mr. Staudohar: MARYELLEN ODELL County Executive Re: Proposed SSTS Repair — Oscawana Management Corp. Oscawana Country Club (T) Putnam Valley, T.M. 51.15 -1 -13 This Department has received and reviewed the most recent set of plans for the above - mentioned project and offers the following. comment for your consideration. 1. Topography is to be provided in the septic area. 2. All existing seasonal water lines are to be shown. 3.. Pump chamber is noted. as.'- xisting" in the plasi view 4. A pump chamber with H2O loading is to be'provided. 5. Please show all areas of ledge. This office will continue its review upon consideration of the above - mentioned comments. Please feel free to contact me at ext. 43157 if any questions arise. Sincerely, (::joseph S. Paravati, Jr., P.E. Assistant Public Health Engineer JSP:cml PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES t• RE: Property of 0 Diu -AW- _M�ftW �• Located at AM!ij —44& 9!2D TNtff/t1i'ax.Map # 571, t3" Block el Lot 13 Subdivision of Subdivision Lot # !-- . Filed Map # Date Filed Gentlemen: This letter is to authorize 6V41414 eotwj _W_ F0,54- a duly licensed Professional Engineer 1Z to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, Miles 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 treatment 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.„# t)6_ Mailing Address.. „gSt.Q tLAtiE 150116 IM, M state l _ Zip i D5`6"7 Telephone: q L4 L ..3& :. z ySul._ -ours.... y.y Y , Signed: Awnerof�o /� / s r -A� (O WO Mailing Address: Z61 � /! V9-K- State Zip, Telephone: /Do Form LA -97 Putnam Coumty Department of Health Division of Environmental Health Services SSTS Repair —Final Site Inspection Date: Inspected•by: T),42etj Installer7-0r,&-i_ Street tree qqatid,6: Owner:. j),sca4,ai9 /I To": _Re air Permit -TM4 IfL.457:- k_v3- 1. Type of System: Conventional 0 Alternate 0 Comments: 2. Se tic Tank I Yes No N/A Comments -(L4_,:P a. Septic tank size '000-. 1,250 ... other ..... ej b. Septic tank installed level ...................... F c. 10' minimum from foundation .................. d. Dis1ribution Box i. All outlets at same elevation {water tested) ... ii. Protecded below frost ................. iii. Minimum 2 ft. Original soil between box & trenches e. Junction Box — �ioMrly set ............................... f Trenches i. Systeiri completely opened for inspection ii. Length required Length installed_2Lt,_ .iii. Pipe slope checked ................................... Installed according to plan ..................... v. 10 ft. from property line — 20 ft — foundations ... vi. Size of gravel % -1 V2 " diameter clean ......... vii. Depth of gravel in trench 12" minimum ......... via. ''Ends ca ed ....................... V g. Pump or Dosed SLsteLis 3. SewaLe Sntem Area -7 Y a. SSTS Area located as pera roved plans 7- b. Fill section — VI/ c. Distance from water course /wetlands L/ 4. Overall Workmanship a. Boxes properly grouted and installed correctly ........... V b. All pipes flush with inside of box ......................... V/ C. Backfill material contains stones <4" diameter ......... V d. Curtain drain & standpipes installed according to plan V oo, V e. Curtain drain outfall protected & d to exist watercourse V/ f, Footing drains discharge away from SSTS area ......... 9. Erosion control provided ..... ....................... Additional Comments: b,<- k, Yfi) 7/ RFS1 Rev - 011312 1.11 i rc,t ,1 t �1. DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYS'T'EM Owner: I r -eS d►(- y Address: Lmted at (street): OSCeeet"O R 4 � �7 ej,4 TM # Municipality: l' WI;04j Watershed: SOIL PERCOLATION TEST DATA Witnewed by: Date of PnHo"9 -- Date of Percolation Tat: Notes: 1. Tests to be repeated at some depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e., < 1 min for 1 -30 min/inch, < 2 min for 31 -60 min/inch). All data to be submitted for review. 2. Depth measurements to be made from top of hole. Foes DD47, P81 of 2 min, Notes: 1. Tests to be repeated at some depth until approximately equal percolation rates are obtained at each percolation test hole. (i.e., < 1 min for 1 -30 min/inch, < 2 min for 31 -60 min/inch). All data to be submitted for review. 2. Depth measurements to be made from top of hole. Foes DD47, P81 of 2 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST (HOLES - _-DEPTH G.L. 1.0' A 1.5' l et' 2.0' 2.5' 3.0' 3.5' 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 70 8.0' 8.5' 10.01 - Indicate level at which groundwater is encountered 3 Indicate level at which mottling is observed Indicate level to which water level rises after being encountered Deep hole observations made by: _ii Date S' Design Professional Nafine: Address: Signature: Revised July 2013 Design Professional's Seal JDMSION OF ENVIRONMENTAL HEALTH SERVICES DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTF-M (ywner:. _�ufo.AA ��o ¢ e e Address: Located at (street): 01\ (r 3 5 6 TM ;* S1.I5 Section: _ Block Lot Municipality: `�nA I� Watershed' SOIL PERCOLATION TEST DATA Witnessed by: Date of Pre - soaking: Date of Percolation Test: l Hole No. Run No. Time Start — Stop Elapse Time (min.) Depth to water from ground surface (inches) Start -.Sto Water' level drop in inches Percolation Rate lain /inch 1 Z 3 I 4 1 2 3 4 1 2 3 4 2 2 - 3 4 Votes: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each percolation test. hole. (i.e., < 1 thin for 1 -30 min/inch, < ? min for 3 1-60 tniniinO). All data to be submitted for review. 2. Depth measurements to be made from top of stole. Form DD -91, pq ; ;)t 2 TEST PIT BATA I . DESCRIPTION OF SOI✓S ENCOUNTERED IN TEST HOLES Indicate level at which groundwater is encountered Indicate level at which mottl# is observed A-10&e Indicate level to which water level rises after being encountered Deep hole observations made by: AAA Date. Design Professional Name: Address: Signature: Design Professional = Seal DEPTH "I H6te C --- - -- HOLE # HO L_E G. L. 1.01 2.5' 3.0' 3.5' 4.0' 4.5' 5.01 5.51' f 6.01 7.0' 7.5' 8.01 8.5' 10.01 Indicate level at which groundwater is encountered Indicate level at which mottl# is observed A-10&e Indicate level to which water level rises after being encountered Deep hole observations made by: AAA Date. Design Professional Name: Address: Signature: Design Professional = Seal � .y^ All � � � � . _ � t} • !r a J- Fl — - �____- r IN 0 Jl AIR WATERLINES -'.. ------ I - A LL WATER LIW WI lg A! P, A FEET iiF THE NEW WA�__ WERE RELOCATED A MIN F 1 OP AWAY FLAG WE. NP 7-- V IGNM A""Al, JCS R35 IPE 7;&I> IW�M&OPAL R.- REiE MP c ER WitIMANHO E AND A E tW_=.o V Il MAT bw --m-d cc -499.5 — I* 7. F bw-499.5 7 7 7 -- - --- - - C�_ . . .. . .. . .. L-' ,VIEVVPORT 7. . . .. . .. . . . . .. . . tw-502.0 VAL GONCRE I E SEPTIC TANK. IE PLASLTIC TANK A PLACED, �CK INTO HILLSIDE WATM fMHT MZHOLE FRAME\ ND COVERAT GRADE 7 i WALL WATERPROOF MEMBRANE it 0 14 nt4';L2" E-TER 0 -I FORCE-LINE- 7. '7f - . . . . . . BEHIND WALL 'WAJ COCLOSE VIEW 7. -IEM 7. 3. CULTEC 180HD UNITS IN (5N BOX_ L-' E S4 BED OF GRAVEL WALL 7 . 7 P4,,o -Soo POSIT! GRADE ROM F 1SLOPE TO WALL 7 7 1 7 7 7 7 7 7, TOPOGRAPHY BEHIND THE 77 - qyqTFm m FIELD ESTIMATED w Ilk* E�XISTIIjG:_-qP-TOTHE;�� 4 7 �415XISTING_SE fAkk7 _7 7. 7. 7. UTILITY & GRADING PLAN: SCALE: 1" =15' THIS IS TO CERTIFY THAT THE PUMP I tz, i wAo CONDUCTED BY CRONIN ENGINEERING, P.E., P.C. ON APRIL 27, 2016 WITH A REPRESENTATIVE OF THE PCDH. THE PUMP TEST YIELDED THE FOLLOWING RESULTS' PUMP ON @ 26 }" PUMP OFF @ 18 }" DRAWDOWN = 7.5" CERTIFICATION OF CONSTRUCTION COMPLIANCE 'THIS IS TO CERTIFY THAT THE SEWAGE TREATMENT SYSTEM WAS CONSTRUCTED AS INDICATED ON THIS PLAN AND THAT THE SYSTEM WAS INSPECTED BYME AND THE PCDH IN DECEMBER OF 2015 BEFORE IT WAS COVERED OVER THE SYSTEM WAS CONSTRUCTED IN SUBSTANTIAL ACCORDANCE W(TH ALL STANDARD RULES AND REGULATIONS OF THE PUTNAM COUNTY DEPARTMENT OF HEALTHAND THE NEW YORK STATE DEPARTMENT OF HEALTH' pxyd "n.,W ,_,�,',f.,�y�7. �•._I" �,yW'K'iReY�.ti N8$°39'(I10�. LOCATION' . x 0' TO 6" POSTING PROPERTY LINE IM23' 6"T042" 39S------ -- -- - ---- -- EXISTING 7 CONTOUR 310----------- - - - - -- EXISTING IIYCONTOUR 4W76 SPOT ELEVATIONS c/rc SOILS LABEL q= DEPTH t':SOII "CLASSIFICAITON'a 1 LOCATION' . x 0' TO 6" TOPSOIL `DI 6"T042" BROWN SANDY LOAM W/ ROCKS START 8:32 STOP 8:50 6 MIN 42" 7048" BROWN SAND & GRAVEL, WATER@ 36" START 8:50 STOP 9:08 6 MIN 0 "TO6" TOPSOIL �D2 6" 70 42" BROWN SANDY LOAM W/ ROCKS E ( CNNTER OF".. 42' TO 48' BROWN SAND & GRAVEL, WATER Q 40' r WALL ;CURVE); DEEP SOIL TESTING CONDUCTED BY CRONIN ENGINEERING PE PC ON JUNE 03, 2015 PERCOLATION TESTING M DEPTH ` ;PERCOLATION RATE LOCATION' . x • F'1- 24" START 8:20 STOP 8:32 4 MIN^_ 54.0' 40.5' START 8:32 STOP 8:50 6 MIN APPUCATION RATE 1.0 START 8:50 STOP 9:08 6 MIN WITH WATER 8" FROM,BOTTOM, LE. DROP FROM 8' TO 3' PERCOLATION TESTING CONDUCTED BY CRONIN ENGINEERING PF PC ON JUNE 04, 2015 I FIELD MEASUREMENTS AS TAKEN BY CRONIN ENGINEERING PE PC ON APRIL 27, 2016. i r i OSCAWANA MANAGEMENT CORP. COUNTRY CLUB ROAD PUTNAM VALLEY, NY 10579 1 SEWAGE TREATMENT SYSTEM DESIGN BUILDING TYPE LOCATION' . x A';(HOUSE I RNER ).. B(HOUSEm COORNER` Y' ). C (CENTER QF T/4NK) 54.0' 40.5' 1 TO APPUCATION RATE 1.0 D (OUTLET SIDE '67.5' 51.0' OF TANK) SEPTIC TANK SIZE & MATERIAL E ( CNNTER OF".. FILL PROPOSED UP TO 24" FOR i r WALL ;CURVE); 61.0' 39.0' 1,000 GAL. F CURTAIN DRAIN NO CURTAIN 4_ F (CENTER OF '�' i .89.5' 59.0' -' WALL�CURVE)', DOSING REQUIRED 146.9 OR G (VIEWPORT);y :86.5' 51.5' l; H (VIEWPORT) 168.V 36.0' .1 (JUNCTION BOX) 63.0' 33.0' FIELD MEASUREMENTS AS TAKEN BY CRONIN ENGINEERING PE PC ON APRIL 27, 2016. i r i OSCAWANA MANAGEMENT CORP. COUNTRY CLUB ROAD PUTNAM VALLEY, NY 10579 1 SEWAGE TREATMENT SYSTEM DESIGN BUILDING TYPE SEASONAL SINGI #OF BEDROOMS DESIGN FLOW 150 GPD/ SOIL PERCOLATION RATE :. 1 TO APPUCATION RATE 1.0 ABSORPTION AREA REQUIRED 600 SF = 300 ABSORPTION AREA PROPOSED 3-CULTEC SEPTIC TANK SIZE & MATERIAL 1,000 GAL CO' FILL PROPOSED UP TO 24" FOR i SLOPE IN PRIMARY SYSTEM DOSING SYSTEM 1,000 GAL. F CURTAIN DRAIN NO CURTAIN PUMP CHAMBER INSIDE DIMENSIONS 93.5' X 49' = 7. PUMP CHAMBER GAL PER FOOT 239 DOSING REQUIRED 146.9 OR DRAW REQUIRED DRAW AS TESTED 0427 -2016 7. WATER SUPPLY: PRIVATE (COMMUNITY) WATER FROM EXISTING DI WATERSHED BASIN: HUDSON RIVER PU iT NAM COUN IY UEr OIVISIDN OOF�ENVVV RON APPROVED AS NOT p :APPLICABLE RULES A PUTNAM COUNTY H€4 TURF & TITL REFERENCE NOTE THE PRESENT SITE CONDITIONS WITH RESPEC SUBSURFACE SEWAGE TREATMENT SYSTEM A BE COMPARABLE TO THE TIME OF THE ORIGIN THIS REPAIR PLAN WAS INTENDED TO PROVID1 SEWAGE TREATMENT SYSTEM FOR THIS SEAS NOT INTENDED FOR YEAR ROUND USE.