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HomeMy WebLinkAbout2529DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51.19 -1 -6 BOX 22 02529 go NMI did. r.Lg rL k I T �r I- �. , F �,� T ,,. 02529 EJ 600Z/1',Z/9 PUTNAM COUNTY HEAQ :)POSAL FOR _SEWAGE TREATI Internal Use :R1/ICS /aaoo'asegsai , nnn�n� / / :dq EM REPAIR PERMIT # `M"141 Repair Permit issued in last s years ❑ Not in Watershed Repair within Boyd's Comers, W. Branch or Croton Falls Res. 04 Delegated Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION OWNER'S NANIE MAILING ADDRESS APPLICANT S Y77 Namee�& Relationship (i.e., owner, tenant, contractor) / DATE �� l� ✓ FACILITY TYPE s 6 01d -00,l PCHD COMPLAINT # PROPOSED INSTALLER � � ?'� /�/%�✓ _ PHONE # ?�t,S = 6 2- G ADDRESS b8�4~ R A/77VOI .UA %REGISTRATION /LICENSE # /0 74r 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. as owner,agree to the conditions stated ,6jt this form SIGNATURE (Z. ; TITLED A/ /)'mod' DATE l (owner) I, the septic installer, agree to comply with the conditions of this. permit for the septic system repair SIGNATURE �' -Y' TITLE DATE 7 jam- y Z o� (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 backfilllled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved Proposal Denied ❑ . I I ns ator's Signature & L ifeln suowwo� anp ry� �� � '80'0) 'Pan 4M A40" 11V'wr! � O (T o 7 aillO 1�a a, )o aoua7da» ato � a e J8PUn P202311 sl7m 1 e y x irn te Repair proposal is in compliance with applicable codes COPIES: PCHD; Owner; Installer PC -RP 99ML Yes ❑ M Rev. 2/07 anla»ay ! «. v ­N n T eTTnc»nXT nnnr'% --nn T A T ennrT rRTTTVnTTTQ 1VTTM FILE NUMBER 992 DATE JUL -23 03:14PM TO 82842942 DOCUMENT PAGES 001 START TIME JUL -23 03:14PM END TIME JUL -23 03:15PM SENT PAGES 001 STATUS OK TIME JUL -23 -2009 03 :15PM TEL NUMBER 8452787921 NAME ENVIRONMENTAL HEALTH FILE NUMBER 992 * ** SUCCE}iSLS}FUL.TX NOT ICE . 600Z//:Z/9 Z9�SR Ct7i�U ALt CIS E�`VI Cmb /ctzoo asegsala?a xevn� / /_dilt; PRC)lPC)1SAL FpR SIwWAG4E TREATMS/JF SYST) =M FiEPAlR u�'ES d Internal Use C>-jy PERM -7 - If �J ® Repair Pcrrnn i-ueu 1. lad's years Not In Watershed Repair within aoyd's Gomars. W. Branch or Oroion Palls Rea. Oelogated [� Repair wlthin 2OD 1t.. or'a watarcourao 4r CEGmapped _Un d 0 Jai Rt Rev10W SITE LOCATION -C--4q e'LL- TOWN fb -r KA iv G OWNER'S NAME -17- �JtR PHCINE wq�m. MAILING ADDRESS C 5 AF+PLICANT c.� G ^��7 Ngmsp�& Re/aticnship (i.e.. owner; [anent, contractor DATE -p ✓- FACILITY TYPE eU O'!_QO-417 PCHO COMPLAINT 0 PFtOPOSeD iN STALLBR R �,, /L, z-- /� /= _.s,r.3�1/ PHONE a �4-t,� -- r� �•-- G = 2�CS,,'� Al7D RESS Sr:ET O �/2. ' R /S A /T7V1fJ-I i . \f/iGK /ma0tSTRATIQN /LICENSE # / J �S Proposal (Inolu�da a a®parate slcatatt locating tits house, property linos, all adjacent walls within 2D0 ' Teat of repair and tnet IOGation of existing aired proposed system) NOTE: The Depparb. (5nt may require submittal of proposal from licensed protessionesl depending on the nature and extent of the repair. _ 1, as owner.egree to the conditions stn. this form S1C3NATURE �^ fir^. TITLEO�h / ✓� �- IA-11 (owner) 1, the septic instarlliar, tagrtle to comply with the conditions of this.parmit for the septic system repair 7 pn>$tallaY7 Proposal aoarovad w18t tfaa foltowlno condttiona: , 9 . Procurement of any Town Permit, tf applicable. 2. Submission of as built repair eke=)% by thn aeptic syertam instatI- within SO days ofthe ropair, in duplicate showing! a. Owner's name, Site Street Name, -row. and Tax Map number b. Location of tnat mIl ®d aornponents tied to two tlxed polnt- c. System clascrtptfon (e.g.. 9 260 gal. Concrete septic tank, otc.j d. Installers' rums and phone number 3. System ropair to by pftrforrne,d In ftcoordan- with th0 above proposal and conditions 4. The proposed SSTS repair Is considered a boat fit dosign and theta Is no guarantee to the duration at wliloh the completed SSTB repair will lunctlon. S. No completed work is to b¢ baekrtlted until autFtorization to do so has boon alb tned tram trio, 1:)eapart.. ant. 11PtTERN/D.1.. UStE. ONLY Proposal Appirovad Proposal Derlieid 0 1 soectors Siono-itur0 &L on bate CpP1ES: FpC:HO: CDO- r; Installer - - PC -RP 9911AL. - Rev. 2/07 fr3o � o sttoseoop{] :nom -.L 80-Cl $trxou$ $ry aid F S a 4J40 �Q►S� LAK.Er 0 S C W 3Q "00 E AiN LINK FENCE N � � p,Pe e•+ °"eat• ` I Qy s3, `� . r ` Stem PIPE - Y' "0.3, o cLBRa wea � lR 7-` 5, A 4 i 1 3 ZowS ��o 8o st1,FZ ± ' RH _ � OS� FP.vt 6 TT •20 3 �4.4,cGENR � I \a Q � " 1 STOFIY 114 W hW000 z. 4.4 't '� •N 3 Ova RED 3 ; o : Q N� WCLL• � o r P � �°yNG /9e•ee o to D•00' j OZ .i7' 3O'E ,e o" Poi E .✓a AS'oGy _ .._...._. ILL ROAD lA\T J�[ L w� v .._ . ... _- �. 3 bi- tti .v.11 rRA +'E i OF F1LE.0 MAP nl LE TO LOI tsE( p RP 1S GEII'C1FlE0 iLE.FERF,1`1 f * Tws, E pt�1L`1 TD' p � . i . -0G5 ppFi. - L Rte �tiEPASC�.D EST 1'1� -a MP_-•- N —`"" Elk CN�,nP�t14�� THE �KRZIONAL AS50CiRTNOy�`Tt�.���TE �N I,.�� 14 E F1 �1zEG� R� PL low s CARl�GE lit IS: Y TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE #__L_ HOLE # HOLE # HOLE # HOLE # G.L. 0.5' S 1.0' Casa ve- ! 2.0' 2.5' 3.0' 3.5' r 4.0' yi r Z 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5• 9.0' 9.5' 10.0' Indicate level at which groundwater is encountered . & 9 ©A.) Indicate level at which mottling is observed Aj oAj r� Indicate level to which water level rises after being encountered Deep hole observations made by;r� _I ��t� Date %0Z23/ ©� Design Professional Name: Address: Sianature: Design Professional = Seal p. PUTNAM COUNTY HEALTH DEPARTMENT . DIVISION OF ENVIRONMENTAL HEALTH SERVICES THIS IS NOT A REPAIR PERMIT PROPOSAL FOR EXPLORATION OF SEPTIC SYSTEM FAILURE All information below must be fully completed prior to any scheduling SITE LOCATION OWNER'S NAME MAILING ADDRESS N !/L TM #�f PROPOSED CONTRACTOR /INSTALLER PHONE # ADDRESS Pt,'-r,9,4 M !/ /44 i /j%Y. REGISTRATION /LICENSE # 107E Reason for exploration: ❑ failure to surface ❑ back -up in house ❑ find limits of system for repair 0 other (explain below) kvoC, L FOR COUNTY USE ONLY Inspector's Signature & Title Date r Appointment Date: 7A -1 Time: /per oc� kly:excel:septic v. l.. •�.� b - �XSi3iM4.� F `S 4:�X^' b �' � uoC .J3 3"r`4L_ A' C"' /•� c ROCI(� •-� ` 2 ° CANOPU9 HOLI°by S wa MO'f10H •^^-8 OF THE 1W3H aLES R REACH' RD hO KNOLLS y Nlbl OW N O i® '1.w 44• �' H m z ROS F z S AV 30OItl a SHAG n S a Off® �„ ^ HO" 9 < DUSTY �.../ `4h0 y Y LA c } MESDgIE,;" Utl OAa O AO(, _ x S VIEW A �.., _pztS APPLE `C LAKE OOKOU m t`d ;VIE �aa L O,a A SMOR DR PEA DR C•(\ \N LFF -.� Ge 1 `` �,.'� ......:......:.....� O .010 G q 0y�c Y • \ �FP� Oa ' \ NO 1 F } 16q l 3 °n 3 o� x ( 'i' : .r S /•� a -^`x :,3 x all-; �w g D i�'srs 3c 3 a �, ILDW my •. 3ti0 Sq \ �%. • �. v s� `�� �t5� <y'°�NF �..� -. «.. ..._•,. -�......__,._.- o ll .c AyM yd 9 pA Gb 9%ila �l . RD' o Oq S UG a. ODbS ` "- _•L..Q(' O 6 9 q m ON f/Oq �._ o. kL a�� I OW tl3-1. pg� c ®tea yP` kF Od .7 y ,Q173MSOg 9 L. � i 1 S � J / BRUCE R.. FOLEY Public Healrh Director LORETTA MOLINARI R.N., M.S.N. Associate 7 Pit 4,;- ..Health ,director...:, c 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 January 26, 2001 Kurtenbach 21 White Hill Rd. Putnam Valley NY 10579 Re: Addition- Kurtenbach- White Hill Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 51.19 -1 -6 Dear Mr. Kurtenbach: 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 starrlp form this Department dated Janua�y 26, 2001 The addition is approved with the following conditions: 1. The total number of bedrooms must remain at Two without prior approval by this department. - The.�ar -e' afther' existing sewage disposal systeln, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. ML:kg cc: 131 Very truly yours, Michael Luke Public Health Technician I i 3~ BRUCE R. FOLEY Public Fealtk. Di,ectrp_ O.RETT'A. -1t OLI AF-1 R.N.; M ..SN. - Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845j 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 PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY ,+ `7- n STREETi TOWN /, TX MAP# a i ` NAiME . , 6 e-- 01 -i PHONE Vc S- , C 1' PCHD# 2 — 0 MAILING ADDRESS cam! / / /r° DESCRIPTION OF ADDITION, NUMBER OF EXISTING BEDROOMS__Q _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 sub.-rut this-form and the Ulowing to Putnam CounfyIRialth Dept., 4 Geneva Road, 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 USE Comments Feb98 BFhouseguidelines /oo 4�oc, 1�,el?71- 4cl. /V/ TX co b Cl) cm rRB 11'2 8'3 r3 3911 175 OD cm rRB 11'2 8'3 r3 3911 175 LOT 4 tv CO AKER . / 0.3 °l ACRE t .� . I KoN OAR 5 T u It,,i \N000 FLAME D\N LL k: L . jo if Cl co V) T 1A \ 5 NN P,? 1S c L?,,v \ F i f-D ONLA TD. CAArkSf- MRMHMT-rAN [SANK _AND NR'TIONF\L MSOCIRTMN 1�LKINV--TVA PRUND NGENC'j L-TO T1-TLC Y\ p P U 0 -L Lk S 4z CX S OZ: 1-7 30'F- 100. 00' L 07 ?- %.,-",Y y PREPARED i'OR �.Si� MA�iTE� L N ELY m- A SITUATE I N THE T DVN N OF PUTRKW VRLLEI PLITNKM UUMT`i C R L E- I INCH .� 30 P ELT OCT 2 I at V) li S \3 R\J EN E 0 [I\ I T. L"P%R.LE-.S 1100LUV-01 tIL•N.S. \-\(-CNSE Nib. oLtq 4C1L4 S6 ELII.R S7.1, PIAONC. lit'i 1111 I1�8 CM '49 9 t PA S OZ: 1-7 30'F- 100. 00' L 07 ?- %.,-",Y y PREPARED i'OR �.Si� MA�iTE� L N ELY m- A SITUATE I N THE T DVN N OF PUTRKW VRLLEI PLITNKM UUMT`i C R L E- I INCH .� 30 P ELT OCT 2 I at V) li S \3 R\J EN E 0 [I\ I T. L"P%R.LE-.S 1100LUV-01 tIL•N.S. \-\(-CNSE Nib. oLtq 4C1L4 S6 ELII.R S7.1, PIAONC. lit'i 1111 I1�8 CM LA1<E OSC.AVM!N. AN EAST NO.?- ry 13 00 E C�Iq�N lir:� ♦Nao � io ' 1 I t1r 0.05 tj '. tq / 10,880 T ` , L OT Z �� v-luoo itio�+ gnn.y \ ;N l SToi,-4 "' W D00 FLAME owes.k- C. I� M ' 03 e� ; L rj 4,1 S of IT 30"E IUD 00' ` I�P.P 1S CLEIT \FIFO I, C-1 _C) NL`r TD- SSE NA FAUNATTRN [3ANIC N RT I D N P\ L A'iSDC l- T» N 1NLTN: PIZCGNO NC,ENC`1 OP. i �TLE KPP 11.y.'Ua L`1S Pt I ur% REFI_REl`1C E T O LpT 3, SU l OF FI l E D MAP ND. 31.-7- K L h u v R S V R% " E4 N\ P "PRE..PI7ilED FQ9- q [ice. ST "� 1 1 T 0.� SITUF\TE. IN THE. TOWN DF PUS i�P�M y F1�LEy ,� �'tli'�1ANi COUNT N EW N D RK S LP�LE. l INCN 30 F EE-C QCZ. 2.10%6H r M0 . CERTIFICATE_ OF OCCUPANCY Certificate of '0 1 ecuipanc* y - „� No4_ :" ----- Application No..k7j%Z0.0:. �� 7 Location of Premises x 'N - .............................. ,a. =� ' l having. heretofore filed an applic tion for a - building permit pursuar.o the- -ring Ordu ce, Sanitary ..'Code, Building Code an( the Laws in effect in the.Town of Putnam Valley, Putnahl County, New York, shaving paid the aquired fee therefor arid_ .the: undersigned having by .personal inspection ascertained that the applicant has- subsequently.; proceeded with the erection or improvement .of the. proposed structure in compliance with .the requirements of -the laws as aforementioned and that the said work and materials met every requirement of the laws as aforementioned and that the premises have now been fully completed and are ready for.occupancy pursuant to the provi- sions of law, Now, therefore, this certificate of oecup ney is hereby issued under the seal of the Town of Putnam Valley this .... __ _ day of.... _.__......,” 1 Not. valid unless signed in inlc by a duly authorized ages r"TOWN OF P.IUTNAM VALLEY, NEW YORK of and under the seal of the Town of Putnam Valley. j BY[,• - --------- ---- • r :SIGN DATA SIiEMOT - SEPARATE, SL• -MRAGE SYSTEM White Hill Rd Owan . 0 caana.. L3k o;Z..s . w;e,, Acres . Herbert N. Bryant B1ocI� owner , ............... ........................ atershed.. Oscawana .Lake ................. Lot..... ?................,., ource of water supply: drilled, driven, Lot Area ... ..16sM....,.... dug well, spring, public None Bldg. Type ... Frame. .... , ... . o. of rooms..1�..Bedrooms..2 Future....... Occupancy ... 4 .ReQple .n .Summer Home 'ixtures: Kitchen- dishwasher ... Ka; garbage-- 1�o ----- ---- - - - - -- - --rinder. Ack; Automatic laundry..Na; bath- Yes -1 .o oms . .. ; o tier ........ ................ . :QiAGE FLOW: (200. gal ./ bodroori) ........... .... . (Increased capacity required for garbage grinder .yank capacity. 45a gallons below flow Line; depth air space. .1- •ftr: Wank mater., al. S.tee,7........total del�tliw5ft.......liquid depth .... ieft.,..... , -th......2.'Alf ...7.engt a. , by '.........partition ......... ... . Soil tests: lst..........i;iin.; 2nd...... .... ,,i7iiin,; 3rd.......... min. Soil to five(15) foot depth .............how known...................... Tests made by .. . . . . . . . . . .. .. .. ... . .. . ..when?,,., . . . . .. .. .. . .. . .. • . . , . . lbsorption rate allot add ......... .E.p.s.f.p.d.;Checked by.... o.00 ... *@. Gallons........... requires ........... square f eet botto ;: Rate (Area in. trenches rovided by (describe absorption field) ............................... .... ............. . ............... distributlon box provided........ — ?SABLE i ",2 ;A AVAILAULE ON PREMISES ..................................... ,DRAINAGE OF LA:-1D,. nat; ?al_ X ; artificial ; curtain drain ;(show on (Slret•�'1 fell- drained usable area INST be provided before approval may be j.: s-a- -d `T TC:I 1S IZ and must show all pertinent features, north point, _property lanes, existinS stru.cturos, driveways, water or Las, lin -: :r, v.<a.tor courses; walls, springs, dry wells or drairis for roof or al (.,%- irainaGe; _1 CS CLS :3iS 41 11 SUCIi I'I iii-'UliE CCi;ii'l,:j TL I'I; AliS 1'OI' :0i6 U:iTL DRr1IItii ;3 u�' Si�':I�iGL DISPOSAL AR�,' ,dd and all d .t-ils of a or! :ab7_e se:�f�a�e sys� c:m. DATA SUBI-iI72LI) su .., �1� �. .............. . si£1.1at1.1.:Pe / date owner( ) ; ]3tailder ( Y; If corporation, g ive tit a ..................... . Checked by: existing records( ); field ins- poction( )B;; ......... Date..... �� �. . ..j... . .- 1 • 1 - I I • •� I �_.�� + + 4 4. -'��!. ±'— T��- ��..... {mil �.`... � .e oms • L..; o t11er o • s • • • • • . • . • . e . • e e e • • o o e • , �J�JAGD FLO�J: (200 gal. bedroori) ....... •.• ............. •6000•........,. (Increased capacity required for garbage grinder - SC,!r �':an .::c_ city,:J� -mil a,.. ll.ons. beJ_o�r .f;Lo�: 1 -ina ;. d`,)th,. air.- s 5ace.: Tank material.S•teel• • ......total depth.5ft... • ...liquid depth .... L,ft..... . width ...... 2rb•". .... lengtl..bA ........ .•.partition .............. Soil tests: lst....•.•.6.,,iiin.; 2nd .............min.; 3rd .......... m9_n. Y Soil to five() foot depth.• ... • ...... •how known. .... ,..•...• ... ....,. Tests made by...•.... ...... • .... ....6,. when ?.e........ 6666.....6...... C �1 lbsorption rate allowdd ...... 0..eE.p.s.f.p.d.;Cilecked by. •6.e0.•6....• Gallons.............. regUires ........... square feet bottc,•, Pate area in trenches ..'rovided by (describe absorption field) .............................•. ...• ............. e ............... distribution box provided..........., MABLL' ' EA AVAILADLB ON PREMISES ...................................... ')P MENAGE OF LAID: natural_ X ; artificial ; curtain drain ; (show on fell- drained usable area INST be provided Uefore approval may be i; 7a--d D'=C:I IS It;QUIRt_,D and must show all pertinent features, north point, -)roperty lines, existing structures, drivewa- s, water or gas, lin•:: ^,. water courses; w : ;ll.s, springs, dry wells or drains for roof or ar; iramage;- ;:!1S1'j1tfCi;S T.3L 'dL:� , SUCK I'LAi'tJ;iiS; CCiiiPL_,TI; PLA1S FOR ADi (U.,tll ; DRAIIi.Ara 1 G.V" SE'JAGL DISPOSAL ARIA, and all d .tui-ls of a orl:abl__e^�s- e- I-jage system. DATA SUBI'II TT F:L ..,3. ` �.: .�.. ��' �� �I�f! ............... s i gnatl.l.re / date 0w' "' ner ( )�; I'Liilder ( h If corporat.Lori, give tit • ............... . Checked by: existing -records( ); field inspection( )B; .......bate..... 71 LJb- fc kill[ Pd NY )C)S-)? IN O Oi fi- SO so 11'4 39'1 �m las /Vo i 4'8 3'4 .CK -1 e i s P .:r; 1. -; A �- T!! c fvitff OF HEALTH T - )p 170 R� 0 ��ti� PST ��z � /� si g n at-u It"! "I I �-'i Date 4'6 T6 cn co A- ZEE IN 5'4 jlii -C -;U.,lENTOF HEALTH P UTNI ANI C& P HOUSE PLJ%NS , 'ED FOR BEDROKOMI .-OU I 'f CNEY; Brr � Me -295 io LAUNDRY BATHROOM cn co A- ZEE IN 5'4 jlii -C -;U.,lENTOF HEALTH P UTNI ANI C& P HOUSE PLJ%NS , 'ED FOR BEDROKOMI .-OU I 'f CNEY; Brr � Me IN(Bp T-C Ajj),jr 4 ' CX10-11V9 1-7el<rl- �hl /V/ lolrl?7 - -- -- - - - --- - 39'1 - ---- --- --- ---- BRUCE R. FOLE_Y Pub. ublic Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 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 (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 August 13, 2002 Kurtenb act c/o J. Lynfield R.A. 82 Oscawana Heights Rd. Putnam Valley, NY Re: Addition- Kurtenbac- 21 White Hil Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 51.19 -1 -6 I have received and reviewed the plans for the proposed addition to the above - mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp form this Department dated August 132002. 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. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley . If you have any questions, please contact me at your convenience. ML:kg cc:BI Very truly yours, Michael Luke Public Health Technician BRUCE R. FOLEY Public Health Director LORETTA MOLINARI RN., M.S.N. :.Associate= Wlic• Health "Direclora _ 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 ONLYi STREET 1 I LL TOWN PVfhkg V � MAP# 51. 11 I— 6v 4•I�tTNCW: ?. VV 010- 1C'1,0 N.A',vffi 6 P"6524 O0 G PCHD# t� • r r i I rf HIm. 00 MUM :1& DE-SCRIPTION OF ADDITION - _WN. AW&e) WW 2V nM W/MV \111NIBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS (FROM CERT. OF OCCUPANCY OR CEaTIFICATION 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.'Aa. Geneva Road; -Brewst6r, NY' 110509, Phone 278= 6130. 1. Certified check or money. order for S 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) *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 Corninents F698 BFhouseguidelines L AK.E. 0 S C K% k% k EAST NO.?- 38.00 E. 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FOLEY Public !Health Director LORETTA MOLINARI R.N., associate Public Heafiti Director Director of Patient Services DEPARTMENT OF HEALTH I Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (84S) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: Re: - ► Vk i ta Residence Tax Map Town According to records maintained by the Town, the above noted dwelling r�IS IS NOT _ .... _ ..... . in compliance with Town code and the total number of bedrooms on record is �J This information has been obtained from: CERTIFICATE OF OCCUPANCY: ✓ ASSESSORS RECORD: OTHER ilding Inspector BFhouseguidelines i