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HomeMy WebLinkAbout2707DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 61.-2-17 BOX 23 02707 .. NMI 6L% IN -r, . kc M IN r ILE I IN - 02707 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF �1�tY-IRONMENTAL HEALTH SERVICES PERMIT # q0 � d Located at 227 Canopus Hollow Road own or Village Putnam Valley Subdivision name Date Subdivision Approved Subd. Lot # - Tax Map 61.- Block 2 Lot 17 Renewal Revision Owner /Applicant Name M A R I U S & L O U I S A F L O R E A Date of Previous Approval Mailing Address 227 Canopus Hollow Road, Putnam Valley, NY Amount of Fee Enclosed $300.00 10579 Zip- Building Type I F a m. R e s i d. Lot Area 10.1 No. of Bedrooms 6 Design Flow GPD 9 0 0 acres Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED LAIJIiNU - I,UUU T Separate Sewerage System to consist of NEW- 1,000 gallon septic tank and EXISTING 429 L . F . x 2 4' wide leaching Trenches + 429 L.F. x 24" WIDE leaching trenches (NEW) Other Requirements To be constructed by Water Supply: To Be Determined Address Public Supply From Address ;c d iii _ S-T 1 N G - a ,.�V .r�. a _r, eS s_ I represent that I am wholly and completely responsible for the design and separate sewage treatments sy tem described above will be constructed accordance with the standards, rules and regulations of the Putna thereof a "Certificate of Construction Compliance" satisfactory oQ e� Department, and a written guarantee will be furnished the owns �s builder will place in good operatinzoondition any p of said s immediately following the d the ijAance of the.�al o e. ert � oar TMR r,?P�Q system or any Signed: T H ORS L. STRA P.E. of the proposed system(s) and that the approved amendment thereto and in f Health, and that on completion rector will be submitted to the p or ssigns. by the builder, that said ing the period of two (2) years on Compliance of the original •h Date 6/21/01 Address 61 Mnore Avenue, Mt. Kisco, NY 10549 License# 8129 APPROVED FOR CONSTRUCTION:. This approval; expires,two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. ApprquedJor discharge of domestic sanitary sewage only. Date: Title: S By: � rte copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Desig Professional Form CP -97 BRUCE R. FOLEY _ LORE'1TA M.OLINARI R.N.,..M.S N. ssociate Public Heahh Director A 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 CA"PlPf AU-00 f MAP.9 . k^ r r TTMRF.R 0F.MaSTING BEDROOMS PROPOSED # OF BEDROOMS N (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUU DING 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. Pfease subrmt taus form and t6flowing "to 1'ufifi m Couffy -Tiea all Dept.; 4 verieva Road; Bf&w tdf, `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 4) *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 BRUCE R. FOLEY LORETTA MOLWARI RN., M S.N. Director of Patient Services DEPARTMENT OF HEALTH I Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845)278 - 192 1 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 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: Residence Tax Map —4-- Town a Nm Itiazi Gentlemen: According to records maintained by the Town, the above noted dwelling IS X 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 BFhouseguidelines "7131 dto Building Inspector