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Home My WebLink About2650DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 52. -3 -76 BOX 22 lirs 'Lou . }■ C J t. 1 LI'L r ' ■ L � � I t6 02650 PI `■ Z ■ ■ SITE LOCATION OWNER'S NAME MAILING ADDRESS PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES kL FOR SEWAGE TREATMENT SYSTEM RE Internal Use Only PERMIT # IR d,, OF Repair Permit issued in last 5 years ❑/Not in Watershed f L Repair within Boyd's Comers, W. Branch or Croton Falls Res. Delegated q,"11 Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review ✓ 164 pa&Wj t jqj TOWN � u TM # S1, =?�-Ab �hn (�ir�Pn J PHONE # gyp' APPLICANT ,Oho corlin, a.,30er Name & Relationship (i.e., owner, tenant, contractor) v (\A (� 0 DATE 4, N. 14 FACILITY TYPE PCHD COMPLAINT # A C( -13 PROPOSED INSTALLER �'�sl�uT ,fi hj f PHONE # 2/y-�0.3 -08/9 ADDRESS /49�� /= I�EGISTRATION /LICENSE # L°C'_ 1 a y6 T 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 renair. I, as owner,agree to the conditions �stated on this form SIGNATURE � TITLE (DWOCIZ- DATE (owner) L ,.the septi;.installe�, agfee to:comply with the conditions of_ this permit for the seirtic_system repair a or SIGNATURE TITLE 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 backfilled until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved Proposal Denied ❑ S �� t.— / / -r Inspector's Signature & Title D e Exp' ation Date Repair proposal is in compliance with applicable codes Yes No ❑ COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 ALLEN BEALS9 M.D., J.D. - CommissionOrrfHealth =-.. •,,- _.. ROBERT MORRIS, P.E., MPH Director OfEnvironmental Health May 14, 2014 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 John Cohen 764 Peekskill Hollow Road Putnam Valley; NY 10579 Re: Addition – A- 119 -13 No Increase in Number of Bedrooms 764 Peekskill Hollow Road (T) Putnam Valley, T.M. 52. -3 -76 MARYELLEN ODELL. CduncjJ &eC.UUV6 Dear Mr. Cohen: This Department has received and reviewed the plans for the proposed addition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the approval stamp from this Department dated May 14, 2014. The addition is approved with the following conditions: 1. The sewer hook -up from the proposed bathroom to the existing septic tank will need to .. _ ... _.... -_ _. _. - - be: *ected by this Depart�er. . upon completion -and prior. to bac ing...` 2. The total number of bedrooms must remain at 0 without prior approval by this Department. 3. The area of the existing sewage disposal system and its expansion area must be maintained. 4. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc ... 5. The approval is for the modifications only and does not validate any construction shown as existing that has not obtained proper approvals from other agencies having jurisdiction. 6. This approval is valid for two (2) years and expires on May 14, 2016 Any permits or variances required under the jurisdiction of the Town of Putnam Valley are the responsibility of the applicant. If you have any questions, please contact me at (845) 808 -1390 ext. 43261. Respectfully, ND, �Z—k�4 Gene D. Reed Senior Environmental Engineering Aide GDR:cw Fliil:Ill::ai11'I: =7 1) •!)lil 1��, ''� \�'� :i ,aerie I �1 IIII s�;(: -vll DEPARMENT'QF HEALTH ✓ = I QMM Ro4 Mewstm Nov Yua- 10504 Telepd Mr. (845) 8W1390; Fax: (US) 278 -7921 ADDITION APPLICATION RESIDENTIAL ONLY STREET %o4 2ed,-,�,-Ak (A TOWN Pam, v ( TAX MAP # r3 NAME �ahn �ohe� PHONE CIS- C ?E{- G,4PCHD#' "`�(�1 ��= MAILING n ADDRESS IroLli DESCRIPTION OF *NUMBER OF EXISTING BEDROOMS Z/ 1%M W" OPPROPOSED NEW BEDROOMS 8 * (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 thisaforin and'tlie following to Putnam Coiinty Health Dept:, l Geneva Rd, - . Brewster, NY 10509, Phone: (845) 808 -1390. 1. Certified chec or money order for $100.00.. 2. Sketches of e ' ' g floor plan (drawn to scale, all living area including basement, to be. shown and " ensioned and use of each room specified). (See Section 3.c of Bulletin 3. Two sets of proposed floor plans (drawn to scale - with name, street and tax map #) * Non-professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) 4. Copy of survey showing all well and septic locations on the subject property to the best of your knowledge. Include date of installation known. Contact this office with any. questions. 5. Copy of Certificate of Occupancy from the .Town or Certification from the Building . Department with legal bedroom count of dwelling. OFFICE USE CONMENTS r Li 17 "..3111 'L T7 )3�'! W: Z71 Qq (ISI 14 A -,y F-I v 1 XI 4� 'w, 4 _77 77-7 14 Fl( I-Lpoe 17 lfc IF t.:: Ar If __J IA 1 W �r%s 4 Yi _4 E -N ONLY) SE !PLANS APF ROVEDFOR BEDROOM COUNT ON obmi 32 t 'U�M* EWSIONU !ETEff 1 4 ALL S UBSEET, ORATIONS _FO*TH ESEI H*l % ikuo:m'-:s- -8ml 7r-D-10 I IIE__PCDoH:! FOR � APPROVA ...1, bb �Af E 7-,T _71 _NJ J A I t 4 J - - - - - - - - - - _..._!__�.. .__ ___ __ +_.-- }- . --_r_. _,.._.._ L_._ ..._ ., _.._. -•- -- _..._ 1. _ _ 14 , [. 3 js !7 , ► )a 6I I6 !�:.1�6. tit 3 ► `'' 5 3 , r" E f �I Lb: {. j r � v I t It i • i r t Ct�i�� - TE f .._..�- ..---t ----i 1 —t• "� „� / I �A... . e ..'. t .._..r. :.:..;..__.,.. i �_.r._._.+ -- , r'..� . � _._T _. _ ._.I ' �— - t I t Em an 14 s fE IV it it o.V ti 2A lz 3 qp o.V ti 2A lz 3 ALLEN BEALS, M.D., J.D. Commissioner of Health _n .. ROBERT MORRIS, P.E.,.MPH Director ofEnvironmental Health . February 11, 2014 DEPARTMENT OF HEALTH 1 Geneva Road,. Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 John Cohen 764 Peekskill Hollow Road Putnam Valley, NY 10579 Re: Proposed Addition - A- 119 -13 764 Peekskill Hollow Road (T) Putnam Valley, TM 52. -3 -76 Dear Mr. Cohen: MARYELLEN ODELL County Ezecu6e Continued. review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Your proposal for a bathroom in the art studio is approvable providing one of the following conditions are met. This Department will require that the proposed bathroom be either hooked up to the existing septic tank that services the house or - have_a :ljcenced engineer design a separate septic. system meeting current. codes. A septic - repair permit has been enclosed for your use should you choose to hook up to the existing septic tank. Please contact me at (845) 808 -1390 ext. 43261 if you have any questions. GDR:cml Respectfully, Iv Gene D. Reed Principal Environmental Health Engineering Aide ALLEN BEALS9 M.D., J.D. Commissioner ofRealti ROBERT MORM9 P.E.9 MPH Director ofEnvironmenid Health November 26, 21013 DEPARTMENT OF HEALTH I Geneva Road,. Brewster., New York 10509 Phone # (845) 808-1390 Fax # (845) 278-7921 John Cohen 764 Peekskill Hollow Road Putnam Valley, NY 10579 Re: Proposed Addition - A- 119 -13 764 Peekskill Hollow Road (T) Putnam Valley, TM 52.-3=76 Dear Mr. Cohen: MARYELLEN ODELL Review of plans! and other supporting documents submitted at this time relative to the above regarded project has been completed. The Department is requesting a site inspection of the barn pri o*r to continuing review of your proposal. Please contact me at-(845)` -808 -1390 exi. 43261 to"siet✓up an appointment. - Thank you..' Respectfully, Gene D. Reed Principal Environmental Health Engineering Aide GDR:cml ALLEN BEALS, M.D., J.D. Commissioner ofHealth ROBERT ~MORRIS, P.E.,MH Director of Environmental Health October 31, 2013 DEPARTMENT OF HEALTH 1 Geneva Road,. Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 John Cohen 764 Peekskill Hollow Road Putnam Valley, NY 10579 Re: Proposed Addition - A- 119 -13 764 Peekskill Hollow Road (T) Putnam Valley, TM 52. -3 -76 Dear Mr. Cohen:. MARYEL LEN ODELL county aecu&e . Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. Comments are offered as follows: 1. Kindly submit one set of existing sketches of the entire structure showing all floors and all rooms as they exist. 2. Kindly submit two sets of proposed sketches of the entire structure showing all floors and.all = existing- and.- prapose&rQ .._..__......� ....._...,. aims.- _.�._......._.._.._..__ .._ ._........_.._...:. _ . .... -:._.. . _...._.._.._.....___.___....�.: Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. Respectfully, Gene D. Reed Senior Environmental Health Engineering Aide GDR:cml \ Ir �. 1 .J FROM : TINY HOUSES INC. D AXJ--- Itcowwommm VbWmdB=kV0WWWR=* PHONE NO. 845 526 4753 Sep. 27 2013 01:OOPM P1 COW* BXBC06" OEPAMEW OF HEALTH I YCKk 10" Twqhoum P" 809-13M 1?4=045)278-792l 7 Lgwn AMal Mmm Coact & EMrmed Ad&_on 8!&W Ro: (Owner's Name) 6'a (&ben e Tax Map it J J *76�j __ Address Town:-- ....... Year Built- Amording to records maintained by the Town, the above noted dwelling, is ,in compliance with Town Code. h not in compliance with Town Code. The L%W Bedroom Count is: This information tm Wtk obtained ftom- Certificate of Occupancy: 0d=. The plans for the pioNsod addition are coiWdered: Addition to cxLsft house only Tmdown and/or re-budd allowed under Town RVdations Cpao(Aa Bmldiag I Ccror 6. *'k b4WD(n *IV) ,W S� V\2� S VA bWA' 2013 ON 553-tIO-40--E 12. 524'-54'-30"E 57. D2' 08'- . '. L92-L 915' CA"r — -- 14 9-F- 4G. .-524*-30'-50"E 4 0 D- < 0 ,4 0 ! Fr- Barn CD t t l,� 0 0- to 0 Z C, UJ o W 3-n w A . ....... )-111 Tf.ZZ N 0 Sb % CZ M_oi -.1 -.01E •92 !-'OSEA 0 D E L I- , Re pui-'ed 3.272 Ac. 65'60! W,15EA ODELL, m '.01 -Jos-.oz VA MAP OF PROPERTY SURVEYED FOR Certified as correct to On i Led SAMUEL P. & ANNE E. GIBSON ;i-Title a Mortgage Guarantee Co. and F- 51TUATE IN TH Wfr5t Federal Sayings 8L Loan Assn. of N.Y. "WIVIi iii OF PUTNAM VALLEY PUTNAM CO., N-Y. a Ys ,f c HOSEA ODELL, Reputed i �! HOSEA ODELLReputed : 3° + ' - 520850 "E GS.7S ' c - o'- 553•-10 =40 "E 12.08'. -.. 524••Sd' -g "f 57.9 '7 32'-15' -40 "E 46.46' d' C -- -- .. . 526'4C'SO`E75.G ? 24'-30' -50 "E 4.2T' T•I So "E N v .123'32 =50"E Sat' .. .....Y{ all •••• •• . Wall ... J i • ... rl It _ + i b git H �F � O O d Fr- Barn— . {p I 1 0 J m 1.1 y 1.4'S I Ac.. _ D Fc Goi�tbause 3.272 Ac. o -' W Vacant zsg •J r _ J, l I,w s ., r. Henhouse ....IIpM---� r -I .' 1'[ ••.. .... 11eM..:. 1 ° �y^, o. p .••" � v I � B5LO1 _o£-.G :12N .to.D t:L2 - ,70' 01:21 :92N "S'O I ` M_OD :20:O2N 1O, it :.2�5£M.OL-.fb•.GZN�=•'•: } '- !• �. (455 FA..OY.70:IfN ,. .14'19 M,.04-.04:42N•' � F c Ot•.00•.SCN��' � , _ i .fl'G61A- _ ° :6Y:02N1 . -. H05E-A ODELL, Reputed 3 di :S'Y82h100 •'tbL'61 M..OL80:LbN .•� 00'82 M -UI 05 .OZU i MAP OF 1-5.. ac A. 5CIiE16Eii c _ n8� PROPERTY, SURVEYED FOR f SAMUEL P. $ ANNE. E.- G iBS ON Svrvcyed ae in possession. Certified as correct to United Title klortga9e Guarantee Co. and SITUATE IN THE - First Federal Savings& LoanAssn.of N.Y. TOWN OF PUTNAM VALLEY :: {: ?'tiir.it jti••'. . r a. �4r" PUTNAM CO., N.Y. j Date of Survey- Aug. 6,194,7. 1 � - , -.._ —Val of a Map • dpug. 8' 1947 Ae+ A.S. L c, 1947 _ .. - � L ._ _.._ ""'•��r� .. � jar r: „?. '!l••' ✓:.1;�; }• � ...'1•: -' - - ie r 'r ' r I 1