The URL can be used to link to this page

Home My WebLink About2653DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 53.-3-3 BOX 23 Z 11ra ,, L is T im I -, , I 02653 Public Health DbWor ROBERT MORRIS, PE Director ofhhvironmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 80 8-1390 Fax # (845) 278 -7921 ADDITION APPLICATION RESIDENTIAL ONLY LP r M,V- ` QUELL, County Executive 919 Peekskill Hollow ' Road TOWN gutnam yA11aV TAX MAP # 53.-3-3 Jenn Green' - NAME PHONE 914 -497 -6536 PCHD# MAILING c/o Steven A. Costa, P.E. ADDRESS 756 Palisade Aveneu Yonkers, NY 10703 DESCRIPTION OF proposed.Second Floor expansion. ADDITION *NUMBER OF EXISTING BEDROOMS 2 NUMBER OF PROPOSED NEW BEDROOMS 2 * (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 P»tnam- County Health ,Dept., .1. Geneva R Brewster :NY 10509, Phone: 845 808 -1390, 1. Cued check or money order for $100.00. 2. Sk.e,&hes of existing floor plan (drawn to scale, all living area including basement, to be sbgwn and dimensioned and use of each room specified). (See Section 3.c of Bulletin 3. .fin sets of proposed floor plans (drawn to scale - with name, street and tax map #) * Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) 4. Copy of survey showing all well and septic locations on the subject property to the best of your knowledge. include date of installation known. Contact this office with any questions. 5. Copy of Certificate of Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE CON04ENTS 4. p 6 �BE�ECCA �Vl'!°r�N$Rkis, �No 1i3SI+(" �:,...,• �. - Public Health Director s ROBERT MOIRES, PE Director Of Dwlronmental Health .�. ". -- �-''' :• -W-AR - Sff fL" 17T �]daJFJ,A -1' Courtly Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Town Leal Bedroom Count & proposed Addition Status Re: Jenn Green (Owner's Name) Tax Map # 53.-3-3 Address: 919 Peekskill..Hollow Road Town: Putnam Valley Year Built: 1920 According to records maintained by the Town, the above noted dwelling, is xx in compliance with Town Code. Its not in compliance wrth Town Code. The Legal Bedroom Count is: 2 This information has been obtained from: Certificate of Occupancy: Other: Assessor's Files The plans for the proposed addition are considered: xx Addition to existing house only Teardown and/or re -build allowed under Town Regulations co A ® /I� BuH ' pector Date 5. ALLEN BEALS, M.D., J.D. Commissioner of Health .R\:Ai.RiiS+W..arvT'li OJiWi X�'W/. ��.-:.�..:- w•.tA•'�n Director ofEmironmental Health MARYELLEN ODELL County Executive _ r..LL1- 'ti't-.:�:.:��rny.,.,f :x...r.ln....�.�...•... _ -j -.w .�•4.'•..y...w+.l +_.-.. rr..w ._-. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509. Phone # (845) 808 -1390 Fax # (845) 278 -7921 July 17, 2012 Steven A. Costa P.E. c/o Jenn Green 756 Palisade Avenue Yonkers, NY 10703 Re: Addition — A- 099 -12 No Increase in Number of Bedrooms 919 Peekskill Hollow Road (T) Putnam Valley, T.M. 53. -3 -3 Dear Mr. Costa: 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 July 17, 2012. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at two without prior approval: by this a .: Depar ment:� . _... , ...... _..... _ .. .._ .a..:... 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 modifications only and does not validate any construction shown as existing that has not obtained proper approvals from other agencies having jurisdiction. 5. This approval is valid for two (2) years and expires on July 17, 2014. 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, Gene D. Reed Senior Engineering Aide GDR:cw cc: BI (T) Putnam Valley SITE LOCATION OWNER'S NAME_ MAILING ADDRESS PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL Ii Oik Sf*'1 GE DISPOSAL SYSTEMto Pp OFFICIAL USE ONLY. ,�/" .53• �3 ;3 I- Diok 60 t 0 rL F- PHONE `A7 - -i4 UA- L LP-,V , 11 � 1 /o S -IM9 PERSON INTERVIEWED PCHD Complaint #. Name a arions p (i.e., owner, tenant, etc. DATE 1 11' / 0 'i TYPE FACILITY P<-C-3 PROPOSED INSTALLER 4C/L7` PHONE,?:?: -' 02 f S oa G•9-w �- ' ' � ADDRESS P� �r �L$ r03'2,AEGISTRATION# ®C- 13e 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. W e(.(. 1-- C,ot;& izo T ri A 7-,+#k -'o- iv &A-1 /O®,4 a q G Gi rL k — t� �fi�y4 C4 C 1`4 d' 1'�r,^ i A—k �• o' C ' v4� Cv . I�as owner, r deported a e t of owner agree to the.conditions.stated on this form. SIG NA^ TITLE ?ice % DATE L 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 comers). 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 erformed in accordance with the above proposal and conditions. Proposal approved 0- -f /0,7 pector's Signature & Title IIATE COPIES: white (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99MI, J �t is MORAMS 14STALLED G -11 -o3 t-; r--,&STMjzW SmiATE-5 6 c CO.' TANK P*PP-lNtAW'rK.,K41S,PLAST)6-,' . Lp=,C-AL.(:!4PACJTV 914 - 528 - �oe4z Z- P I eLD -rAN KS.PLA5T?,&..- Mo."L',CAPACITV TOTAL CAPAClTVTK+F1C-1:05,, RLL of < I FILLED -PRivaivAy w Frisi-Er I ---- DL :3 , :� ltj z .1 jREP.LIIKED .1 k sacnoN CROAHEY wjSmjz, C�LLA TD ip * 5TOVC—: -0 HOT H,.o tiE-A-rc-jz N i TK. LTADINTH CE-+t1= nn-ED 2- -FIELD .&)4 Ks t- ISLACK) 40 &a o v.11)k -06 1 DR-A-IN 00- G leAlva-L F plopr---p Ll N r—_ UP MIN - WIT14 CONN. BC oLrrstDc-- WiLl- me-DGE-S INULUULZI LANW, ur tv n—nm a w- EXCLUDES SHADED PARCEL ALONG POWER LINE R.O.W. 1 old ston, SEE 'SURVEY NOTE' NO. 3 HERE, chb, POW PO3SlWa determination FRAME thits, based on ,,, Of Old tumpike right of ray centerflne of tho once of 2 rOft (33 (L) oft the HOUSE eloot loc-tion of 'bUng kWOvW trOveled y, the ths original centerflne 1. unjoom Swing E 46-48'00- W ' — — - -- - - - -- -- :94' E 3.80' dong former 10outim Of ad fim. 176.10' ya„ S 44*00'05* w deed One I ',KSKI is ''t 4• FRAME SHED :r--- ----- - - -- -- ------ re"Ok" Of old S 38*25'00* V Old wood posts 19-92' 41'37'E d.d th. S 4219'10" W HOLLOW S 24*46'3" E 12' COUNTY HIGHWAY N FORMERLY KNOWN AS THE e`WESTCHESTER—DUTCHESS TURNPIKE& I. SURVEY NOTES: 1. The h hereon being lands currently described In Ober 16M .Page based on a survey visible prepared Charles W. Carpenter. The ..11 serving this Property. if any. was not readily vl! e or found and, therefore, is not shown- Lan original notes and possession. computations for said survey, now M this surveyors Alteration of this map by anyone other the surveyor whose signature and embossed seal appears herean, including any erasures, not?tlons, the centerline of 2. The tron PlPeS that Originally marked New York Power fr old wood f;ost Z 2T fanny _ 76.20' 43.60, 51.98' S 40 4710° W S 41 *31'4,c =Brier --- ------------ Jl SEE *MRVEY NOTE' i Possible detamhoflon of d, lkniti6 band on distance of centerline of the odsting kn exact locotion of the origino old wood f;ost Z 2T fanny _ 76.20' 43.60, 51.98' S 40 4710° W S 41 *31'4,c =Brier --- ------------ Jl