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HomeMy WebLinkAbout2862DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.13 -1 -17 BOX 24 02862 & AM COG • v• • iii �•.� • 1 �1' I�• iii 1 N :j + ►� c ` ! i ; 7 PUTNAM COUNTY HEALTH DEPARTMEW . DIVISION OF ENVIRONMERrAL HEALTH SERVICES PROPOSAL FOR SEDGE DISPOSAL SYSTEM REPAIR ` Da 15 :!Q/l � . e>1,0 V PHONE PC HD Complaint # dame & Relationship (i.e, owner,tt, et-c".) /PHCNE + _ �3 REGISTRATION # Prowl (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. s Signature & Date >roposal 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 cannponents tied to two fixed points (e.g.,house oorners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with'the above proposal and conditions. I, as SIGNAT IPgS: W-dte (POD); YeUcw (mn Ei); Pink (Applicant) PC -RP 97 to the above conditions. TITLE Lot s 1 a Area =>5, 000 sq.;�`. = 0.344 Acres , � m PUTNAM COUNTY DEPARTMENT OF HEALTIf DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDIVUDAL ADDITION/REPAIR FORM SECTION A: GENERAL INFORMATION Name of Project Year of Construction Size of Parcel SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. ❑illy ❑Rolling ❑Stee p Slope ,0Erefttle Slope ❑Flat 2. ❑Evidence of wetland Clow area subject to flooding oBodiesofwater ❑Drainage ditches. ��k outcrop 3. Property lines evident? 4 Li ccnt co-pamtrl: Jeff 5. Existing, individual wells within 200ft of the existing SSTS? ❑ SECTION C. EXISTING SUBSURFACE SENVAGE TREATMENT SYSTEM(SSTS) 1. Physical character of existing SSTS area. A. ❑Level 0,Gentle Slope ❑Steep slope B. ' rained ❑Moderately well drained 13som ewhat poorley drained* OPoorlydrained C. Area available for SSTS. (Primary & Reserve). ❑Extremely limited ❑Somewhat limitedomleluate —ft x —ft C. 5 " D. IITSPECTION Date Inspector EL'o evidence of failure vi nce:of failure nEvidence of seasonal failure 07 S - i - -- - - - - -- - - - - - - - - (Indicate North) Y aocs= . --------------------------- - - - - -- - - -- ------- - -� - -- (1) Indicate location of SSTS A. Size and type of septic tank ¢allons LZJIMetal ®Concrete OPlastic C B. Type of absorption area 1. Fields ft. 2. Pits `<�3. Gallies ft. - ___(2) Indicate - setbacks, front street, backyard, and side yard dimensions (3) Show location of well (4) Show location of driveway (5) Note physical features (steep slopes, rock outcrops, streams/wetlands) SECI'IMT E. EXISTING WATER SUPPLY OPWS ®Shared well COIN,a ENTS . 7 /,ividual well M D ' ed ODug OCasing above ground lee", n k V .a SHERLITAAMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health December 21, 2009 Brendan Cassidy 49 Hudson View Dr Putnam Valley, NY 10579 Dear Mt. Cassidy: DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Addition- A- 115 -08 No Increase in Number of Bedrooms 49 Hudson View Dr (T) Putnam Valley, T.M. # 62.13 -1 -17 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 December 18, 2009. Please note, per this Departments site inspection of the septic system on December 14, 2009 it was noted that two of the three seepage pits had no fluid in them. Being the SSTS'is operating in satisfactory condition, this Department will allow for the abandonment of the seepage pit nearest the proposed addition. The area between the sidewalk and roadside retaining wall is to be reserved for future expansion /replacement. The addition is approved with the following conditions: 1. The seepage pit nearest the propped addition foundation must be disconnected from the system and abandon by means ' of filling in. A repair permit from this Department must be submitted and approved prior to construction. 2. The washing machine waste line must be reconnected to the main house sewer drain of which feeds into the septic tank. 3. A certification of occupancy may. not be issued by the local building department until a letter of compliance has been issued for said repairs. 4. The total number of bedrooms must remain at four without prior approval by this Department. 5. The area of the existing sewage disposal system and its expansion area must be maintained. 6. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets etc. 7. The approval is for the ' proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals 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 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention /Preschool (845) 228 -2847 Fax (845) 225 -1580 Sherlita Amler; MD, MS, EAAP Commissioner of Health Robert Morris, PE Director of Environmental Health Brendan Cassidy 49 Hudson View Drive Putnam Valley, NY 10579 Dear Mr. Cassidy: Da,martment ®f Health 1 Geneva Road, Brewster, NY 10509 Office (845) 808 -1390 Fax (845) 808 -1937 Robert J. Bondi County Executive November 19, 2010 Re: Addition — Application Incomplete 49 Hudson View Drive (T) Putnam Valley, TM # 62.13 -1 -17 Review of the revised plans and other supporting documents submitted at this time relative to the above regarded project has been completed. The following was not submitted with your application: A secoii' 111 set p3 Lei: sed_floo platis_ri,.ed- W.bc.stjhmi oi.._ .:� _..:_... 2. Two new sets of the garage floor plans (first and second floor) needs to be submitted. Upon a receipt of a submission, revised to reflect the above comments, this application will be considered further. Sincerely, Gene D. Reed Sr. Environmental Engineering Aide GDR:kly - .s Sherlita Amler, MD, MS, FAAP Commissioner of Health _ Rohe; t *Mor, ise "k E -. ..... N - Director of Environmental Health Robert J. Bondi County Executive Department of Health 1 Geneva Road, Brewster, NY 10509 ADDITION APPLICATION RESIDENTIAL ONLY STREET U � sw \� i� ['TOWN J L ' TAX MAP # NAME + PHONEMS _� � in - Oq b 2 PCHD# -I MAILING l I 105-7q ADDRESS DESCRIPTION OF ADDITION NUMBER OF EXISTING BEDROOMS l' 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., 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: to_be shown and dimensioned and "use of each "room sped ied). (See Secfion 3.c or lsuiletiri' HA-.1) 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 COMMENTS 5. 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)178 -6026 Nursing/ Home Care Agency (845) 278 -6085 WIC (845) 278 -6678 Early Intervention /Preschool (845) 228 -2847 Fax (845) 225 -1580 m 0 -IDLf I TR cy,f n. le r C, i 'q. !an ComeTs Flo 'op 0."( RD of� ok� u 11 Sunnm�� bro NY p LIP 101 0 i of UA(r-4S zz tu <1 5 HUDSON VIEW ST AA VIEW c 0 f 9L x JP ;D m ED 20 ml0 0 < scawana gq\ i LA 10579 21 Opr"NsHo % 0 -IDLf I TR cy,f n. le r C, i 'q. !an ComeTs Flo 'op 0."( RD of� ok� u 11 Sunnm�� bro NY p LIP 101 0 i of UA(r-4S zz tu <1 5 HUDSON VIEW ST AA VIEW c 0 f 9L x JP ;D m ED 20 ml0 0 < scawana gq\ i LA 10579 21 t, SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County ExECUtive. : _ ROBERT MORRIS, PE Director of Environmental Health ADDITION APPLICATION RESIDENTIAL ONLY STREET 'q ULi S(Zfl V Ie UJ�CTOWN L�n 106 0, AX MAP# -14L NAME PHONE___9>n - b.Q p PCIID# i� ICJ MAILING nn Hod5on ADDRESS `1 '�[``'' eu+_60_�" iew lc_ Villeg, NJ. DESCRIPTION OF - ADDITION ®O 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 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 Coanty.Health Dept., 1 Geneva Rd, -.- -- -- -- - -: . :.. re��ster,.Nj� ...105(1`�. ..__._ _ _... �1. Certified money ied check or ti n y o rder 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 ,44. 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. 15. Copy of Certificate of Occupancy from Town or Certification from Building Dept. with legal l droom 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 Brendan Cassidy 49 Hudson View Drive Putnam Valley, NY 10579 DEPARTMENT OF HEALTH I Geneva Road. Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health October 13, 2009 Re: Addition — Application Incomplete 49 Hudson View Drive (T) Putnam Valley, TM#62.13-1-17 ... ...... . ...... Dear Mr. Cassidy: Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. The following comments are offered: 1. Per this Departments review it appears the foundation of the proposed addition along with the related footings may interfere with the existing seepage pits.. 2. A determination needs to be made as to the exact locations of the seepage pits as the -5 il;•t A S11 jqed-m)t---, h.e !bcat-, ns i's approxUr.a+L%-,:. Upon a receipt of a submission, revised to reflect the above comments, this application will be considered further. GDR:lm Sincerely, "qx - � 1 Gene D. Reed Sr. Environmental Engineering Aide 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 Nursing Home Care Fax (845) 278-6085 WIC (845) 278-6678 Early Intervention / Preschool (845) 228-2847 Fax (845) 225-1580 ,w E�i F i s T � I1Jr ( u I �_ - .. ._ GENERAL NU -+ ES: 1. ALI.WORNSIHAhHLC,•ONI"QRM It) RHIC RF,Ol11REMGN'IS OF TIIE N.Y.S. UNIT: ORMFIREPREVENTIONANDBIIR .OINC.CODEANO'yHALI_ CONFORM IO X', I, RF.COtAM1:Nl "IATK)NS f)F THE N,Y.S. StisumG COOT MANUAL. ALL WORK SFI/U.l- ALSO CONFORM TU'THE. RF,Qt11RRMENTti:U1' ANY OTHER AUi1HUlFCfIFT� HAVING .IIJRI�_•DK'TION. THE OWNER SHALL ARRANGE FOR AMU WTAIN AI.L 1 ' REgIIIRF,O P£1;'+�Ii3, IN!:1'E(:1IONS, CERTIFICATES. TES" S. ETC. ' 2. AIJ- FOIJf1L`ATt(_N:i SHAIS,REST UN UNDLSTUHTIE0501I, WMIA MINIMUM DEARINGCAPAQIYOF 2TONS /5F. THEOWNF.RSIHALL 14AIIE THE ACC',:i'TAULL UEARING STRATA TESTED AND VERIFIED IN T14C FIELD. 3. ALL CONCREI Ij tit 1ALL CONFORM 'CO THE HFCIIFIRFl. -XNTS AND RECOMMENDATIONS OF A.C.1:301,B4 "SPECIFICAngFiS FOR . STRUCTUM. C" HNC:REFE FOR BUILDINGS" (f�- 3.CNJ0 PSI). REINFORCING STEELFOR CONCRETE SHALL CONFORM TO A.S.T.M. AG 15 GRADE 00. 1 4. All. NJ-- STCi:i, WOHA SNAL I. CONFORM TO THE Rr ximcMEh1'TS OF'A.I.S.C. SPECIFICATIONS FOR THE DESIGN. FAORICATION , AND EREC.TIONOFSTRUCI'UP.ALSTEEI. FOHBUILDINF 5 -. ALI. NEW- FEELS14 ALLCONFORMTOA .S.T.M.A- 36ANUA•501. C. AIL FRAMING - 11MDER SHALL SE SPr+LICE-PINE- FIR No. I0x °1,200 PSI —E =1.400.000151) 6. ALL £X'FETFtolt�TPA'AIN(i LHMDER AND WOOD 1111-5 SHALL RE (2) 2"X6" COA NO. 2 OR EQUAL YATFI I/," SI'AIRMESS SIEF.L - AIiC,HOR ALI_Y{OOU 1-111TFI. S SMALL RE (2) 2 "X13" 1)NLES5 UTHERVVHSF- NOTED. - ' B. ALL HEADER tNU'I RIMMERS AT AIL"OOF AND FLOOR OPENINGS SHM..L RE UOUOLED. 9, ALLFI— G(iJD. TSIINI'JERF•MHALLEL{ "ATI(IilONS SHAI.I.RF. DOUOLEU. 10. BHIUUIN( SH. NOi F. J"ICU B'{7 OC t i 1 ELECTRIC 1 V OR ' HAL1 LF INSI -AI I TD I14 ACCOFDANCE WIH -I THE STANDARDS AND HEQUIREM£NT5 OF THE. BOARD OF FIRE LINO { :RYJRRCf I'H! N C (' ANDI OCAL ]UES. � ' •'" t CM1",,,. f �•a1,.Y i(t� i 12. ALL FI IIDINC lORKSI IAIJ. OFINSIAI.CED IN ACCORDANCE WITH STATE AND LOCAL CODES AND SHALL(XMVORM TO COMMON l � PRACTICIiS. •(' 4 I . 13. SMOKCDTTT .TORS si wLL RE I•HOVIDI I AIIJACCNT TO GLEErINC AHFAS IN ACCORDANCE WTTR STATE AND LOCAL CODE S. 14. WRIT ILNLI4 WRIONSFIIALLHAYFrRFCED £hl('LI'1VLkSCAI.F0nIMENSIONS. 15. THE CONTR.•{:TOU ANO CJNNCH'VHAII- VVOIFY ALL LXISIINO CONDITIONS AND DIMENSIONS PRIOR TO START ING ANY YORK AND SNALI. NfJrIFY 1111: ANCHHCCr OF ANY AMRIGUITIES 1.111 DISCREPANCIES PRIOR 'JO PROCEECXNC WITH ANY WORK. IF ANY QUF'_S'TION if l if: D - F t 1' F O, D)I IAN VNS! IHII H0H A'; TO THE, INTENT DR OETAIL.4 OF'TF1F TXTAYJINGS.'FI IE CDNTRAC TI HH A1JD/ )R CJWNFR SHALL t OIT ACr THE AN( -.HDF T T )R CLARIFICATION AND /OR INSTRUCTIONS. IF THC C014114AC'IOII OR OWNER FNt_; FO T OI.1,C W TI IF: AUOVF: f 11(X; ; I RF, "THEY. SHALL ASSUMF. ALI.. flE5PON51dILITY F'OIt INF C:ONSFCjUENC1.5 OI'. 'IHEIIH A('1ICli+9 1�6. 1'HF Ot /Mr.R yF1At.1 ARRAN(. L I'CJIt :JUI'FFFYISIffIJ OF'1lfl: (:ONSTRIICT'ION WORK IU INSURE COMPLIANCE 'N1'R1 I HI; CONI RAC 1' L— ._.- »....._ i 17, -C'_` TIT£ R£: +" VF MY M.:•IC;VYI F.UC =E. RFI,IEF AND 1•IRJTESSK7NAI. .IIID(:L'MLNI', 111E SIIdS'l,i EtAS OF THIS PROJECT ARE IN , CC•MPI.IANCC WOO TIIE H£OI IIRFM1IENI'S OF11 tC N£W YORK $TAG} CDNSERVAmf, COLE. �4 .v F 7 I' 1 ' 1 I t 1 _ 1 ` rt III, N,� L t ,•y' ^'MT -tr}1 1.1i1l yCSl %2 , � I _I f ' j 1 • •,� svooe;tTag x' N j_ 7��. 'i-j �Cd'� !i ivlAd�6 ---- ��..__.. -fie'_...-= �5- ..= -.__.__— •�3�i7�6•+�o q�j�l' - I� _ ''��•{• - }' 41_,C ,,.✓y'��- ^.,�11 V�V ! } 1 j^:uiMr l�Kdl lYwJ,lh ;a .f) , f'✓ .j a l SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Brendan Cassidy 49 Hudson View Drive Putnam Valley, NY 10579 I w yo4 � ..t DEPAR?17MENT OF HEALTH 1 Geneva R ,jd. Brewster, New York 10509 f ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health 1 � September 3, 2009 3 1• Re: Addition — Application Incomplete 49 Hudson View Drive (T) Putnam Valley, TM # U2.13 -1 -17 Dear Mr. Cassidy: Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. !'he following comments are offered: ■ Upon review it was noted that t.6 proposed. addition has an entrance door to a second story above the garage. Kindly! �'ubmit revised plans (2 copies) incorporating. garage floor plans: Please also note the ceil.rag heights and if the rooms are heated or unheated. Your plans are enclosed for your use. V'pon a receipt of a submission, revised to reflect the above comments, this application will be considered further. ' Sincerely, t° + : Gene D. Reed Sr. Environmental Engineering Aide r s s, y�. 4� 3: 5, 3; at 5=� 'En �i f; 1; 6r R am A Qu- U-- T- .t� bVi�k� -Qnn- v� vt4Al� to . JdY� eaaz C tl k� aA X45 J alp 04o g 1 � j WORAGE 1T T if 30h8 b G,40INETS� DR. - V_ _ -- - ---- �p -�' �''',rgp2p ,r4O.�p g�J�p-,gT� (MOUNT�FL ArtC�INT' FLU O O&T FLUOR. L_. _ _. AAD.O. ; A.CaD.O. ! i' IL 1 L U.J i r . r ■ 16`- O'x -t -G' O.H. GAM. M ` :~' 8�-06AI' -0" O . GAR. C>R. 9f-8' ELOmm"Offimm' PLAIN a 1 t i .- - 11 / 0 - 1k_/d � , � ■ ■ w ■ ■ w ■ ■ ■ w ■ ■ ■ ■ ■ ■ ■ ■ w ■ t■ ■ ■ ■ ■ ■ ■ ■ ■ w ■ i i �s���l��������� � -ai�a�.���,o� ■� ■nor ■ri,� ifff CIA a. -- - -- - - - PPIWW ■wwwrwrwwuwwo =► �! 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Tax llv-!:Elp ;L': c:5;—,Z- ma= bull -: Ozher lderirdf:3,irxg L-rLEor=ador--- Z'- T--; i I r? t a - - JA i i i E SHERLITA AMLER, MD, MS, FAAP Commissioner of Health L`ORETTA M0LINARI, RN, MSN Associate Commissioner of Health Brendan Cassidy 49 Hudson View Drive Putnam Valley, NY 10579 Dear Mr. Cassidy: DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health September 3, 2009 Re: Addition — Application Incomplete 49 Hudson View Drive (T) Putnam Valley, TM # 62.13 -1 -17 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. The following comments are offered: ■ Upon review it was noted that the proposed addition has an entrance door to a second story above the garage. Kindly submit revised plans (2 copies) incorporating garage floor plans. Please also note the ceiling heights and if the rooms are heated or unheated. Your plans are enclosed for your use. Upon a receipt of a submission, revised to reflect the above comments, this application will be considered further. GDR:kly Sincerely, Gene D. Reed Sr. Environmental Engineering Aide 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 Nursing Home Care. Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health L.ORETTA MOLINARI,18N, MS1 N, . „.....� . Associate Commissioner of Health Cassidy 49 Hudson View Drive Putnam Valley, NY 10579 To Whom It May Concern: ROBERT.1. BONLDI County Executive .r.- ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 June 25, 2008 Re: Addition -- Application Incomplete 49 Hudson View Drive (T) Putnam Valley, TM # 62.13 -1 -17 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. The following was not submitted with your application: 1. One set of sketches of existing floor plans showing existing conditions only. LTheaplans gnust reflect all-,floors the_hQuse mcludingthe haseme t;t�iftallnooms-notft g=their cdimensions :and use: The plans must also be noted as existing ,show ngzo,9?vnex sanam caddress -and �tax�map�nuummbt rn 2. Two sets of sketches of proposed floor plans. The plans must show all. proposed changes as a finished product. fTheselplansgshaul -&als.oirefl_e_ctial:-,floorssiw -the hm.ne =�n—olud ng4heI tha�semen_taith -all rooms noting�thu dunensiorisatuse The plans must be noted as uu�Yi e Lillu pan iii�p iiui�iv► i _ __. ___s .. ; _ . -_ __ _ .. 3. Copy of the survey showing well and tseptic- 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 should you have any questions. 4. Copy of Certificate of Occupancy from the Town with certification form the Building Department noting the legal bedroom count of the dwelling. t-lease pro_vade oL ginal, (zsignature Your plans are enclosed for your use. Upon a receipt of a submission, revised to reflect the above comments, this application will be considered further. Sincerely, -� 1 Gene D. Reed Sr. Environmental Engineering Aide GDR:kly 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 LORETTA MOLINARI, RN, MSN Associate Commissioner of Health. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York I WO Town Legal Bedroom Count ROBERT J. BONDI . 3Cuut2ty`r arcutive . Re: (Owner's Name) Tax Map — Address: vt) ;S© N V I Lc:k -I I VCc- Town: Pl� 1- �JA.1Y) VA L-L Year Built: �— Accord* to records maintained by the Town, the above noted dwelling, is 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: LM.D tp q� Building Inspector 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 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI,�RN, MSN Associate Commissioner of Health Cassidy 49 Hudson View Drive Putnam Valley, NY 10579 To Whom It May Concern: ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 June 25, 2008 Re: Addition -- Application Incomplete 49 Hudson View Drive (T) Putnam Valley, TM # 62.13 -1 -17 Review of plans and other supporting documents submitted at this time relative to the above regarded project has been completed. The following was not submitted with your application: 1. One set of sketches of existing floor plans showing existing conditions only. The plans must reflect all floors in the- house ,- mcluding;the;:,basement, -with all rooms noting their idunensions.:and - use. The plans must also be noted as existing 4showing owner '. s -name, taddress and,-tax map number. 2. Two sets of sketches of proposed floor plans. The plans must show all.proposed changes as a finished product. These -plans should also reflect all floors inAhe home including•the .basement °with all rooms noting their dimensions and-use....The plans must be noted as _. _.. .__ -- 3. Copy of the survey showing well and septic locations to the best of your knowledge. Inc ;lude date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office should you have' any questions. 4. Copy of Certificate of Occupancy from the Town with certification form the Building Department noting the legal bedroom count of the dwelling. =Please provide original ,signature. Your plans are enclosed for your use. Upon a receipt of a submission, revised to reflect the above comments, this application will be considered further. Sincerely, Gene D. Reed Sr. Environmental Engineering Aide GDR:kly 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 ANTLER, MD, MS, FAAP Commissioner of %health . , LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 Town Leua1 Bedroom Count ROBERT -J. BONIDI couniy Exeeuz ve Re: 1,.. S S (Owner's Name) Tax Map #: te I — — Address: 14 l./I D S P Q V I UE , L Lc— Town: A 11/1 V A L-L L Year Built: Accordin to records maintained by the Town, the above noted dwelling, is — in compliance with Town Code. is not in compliance with Town Code. Al_.� .. The'Lepai Bedroom Count is: This information has been obtained from: Certificate of Occupancy: Other: �. vYW Q Building Inspector 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 Sherlita Amler, MD, MS, FAAP Commissioner of Health Robert Morris, PE Director of Environmental Health �r Department of Health 1 Geneva Road, Brewster, NY 10509 Office (845) 808 -1390 Fax (845) 278 -7921 or (845) 808 -1937 August 17, 2011 Brandon Cassidy 49 Hudson View Drive Putnam Valley, NY 10579 Re: SSTS Field Inspection 49 Hudson View Drive (T) Putnam Valley, TM 62.13 -1 -17 Dear Mr. Cassidy: Paul Eldridge County Executive Per your request, please let this letter serve as notice. The proposed repair at the above referenced property has been inspected by this Department on December 21, 2010. The repair (removal of existing seepage pit and providing area for future replacement) was found to be in compliance with the approved permit R- 162 -10. 7Lem are no further conurents:tu be addressed. Jf .`ui1 have any faidier questions, please connlact me at (845) 278 -6130, ext. 43261. Sincerely, Gene D. Reed Sr. Environmental Health Engineering Aide GDR:cw cc: Putnam Valley Building Department MEMORY TRANSMISSION REPORT Dear Mr. Cassidy: Per your request, please let this letter serve as notico. The proposed repair at the above referenced property has been inspected by this Department oa Deccrnbar 21, 2010. The repair (removal of existing seepage pit and providing area for i%turc replacement) was found to be in compliance witlm the approved permit R- 162 -10_ There are, no further COrraments to be addressed_ If you have any flu ---ter questions, please comract me at (845) 278 -6130, ext_ 43261 . Sincerely, Qene D. Reed Sr. Envirorunental Mcalth Engineering Aide Ql?R;: cw cc. .Putnam Valley Building I?cpartment T l a� . .. _ A! �; -? 8 -2011 ? TEL NUMBER 8452787921 NAME ENVIRONMENTAL HEALTH FILE NUMBER 892 DATE AUG -18 11:31AM TO 85268806 DOCUMENT PAGES 001 START TIME AUG -18 11:31AM END TIME AUG -18 11:33AM. SENT PAGES 001 STATUS OK FILE NUMBER 892 ** SUCCESSFUL TX NOT ICE * ** SUarlita Amler, MD, MS, FA-&P Paul Eldridge Comsnfssionca- H¢olth Q+ G'PSOlYJ/ i3SC¢Cfillv0 Robert Morris, PE ,Afr¢ctor ofF�viravn¢ntol X¢alrh Departr>�.e>at of Health 1 Geneva Road„ Brewster, NY 10:5 0 9 C>Mae (845) 808 -1390 Fax (845) 278 -7921 or (845) 808 -1937 August 17, 201 1 Brandon Cassidy 49 1- Iudson View Drive Pv.uizun �l xilc_� , i SC - 1 0573 RC: SSTS Field Inspection 49 Hudson View Drive (T) Putnam valley, TM 62_13 -1 -17 Dear Mr. Cassidy: Per your request, please let this letter serve as notico. The proposed repair at the above referenced property has been inspected by this Department oa Deccrnbar 21, 2010. The repair (removal of existing seepage pit and providing area for i%turc replacement) was found to be in compliance witlm the approved permit R- 162 -10_ There are, no further COrraments to be addressed_ If you have any flu ---ter questions, please comract me at (845) 278 -6130, ext_ 43261 . Sincerely, Qene D. Reed Sr. Envirorunental Mcalth Engineering Aide Ql?R;: cw cc. .Putnam Valley Building I?cpartment PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES _Tl�' THE �I'�- -YRTE� REP_ - _!R _ Internal Use Only PERMIT # 1:� U D _ Repair Permit issued in last 5 years Aa Not in Watershed Cl n � 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;,.J ZleqbWN cr 1 TM # �Za 13 °1 1 7 OWNER'S NAME lip _ DONE # T Z MAILING ADDRESS APPLICANT oc", ii e Z_ Name & Relationship (i.e., owner, tenant, contractor) DATE .r 0 PROPOSED INSTA LER (0cy .) 1: --R PHONE # FACILITY TYPE RZ-S Vt>SL �CHD COMPLAINT # ADDRESS REGISTRATION /LICENSE # 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 d extent of the repair. 7o be- e-em 1 �f,m�n a.1�'aLtor -to I, as owneir,a7,-�M onditions sta o this form SIGNATURE TITLE DA TE �, 2�0/ 0 (owner) _ e1p,1 $r .�r .0 _ . -_1. �t - - - � - - - ihv S6jJc �j�ivF`io iT :C y 0 w iit _. .. _ .. _ .. _« _ __ - •_ ._ SIGNATURE TITLE 0w /1,64— DATE r (Installer) 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. S. 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 Dat Expiration bate is in comDliance with Yes O No COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 Sheet L of�_ PUTNAM COUNTY DEPARTMENT OF HEALTH g iA, AX.01iai A'X A:, A iJa N i. i llT! Yl'J i�d1 L'S FIELD AC]['IVITY REPORT NAME: L',my TPI• AM RFSS: 1� hUso, ✓,,&,&/7)t, 'R yAA /VK Street Town State Zip PERSON IN CHARGE OR TNTFR VTFW M I. �i2 a✓t �a� � TlatP /a2 Zg- / Z/8 Name and Title TYPE OF FACILITY: S�P Fez.4, /i 01111 I Signature and Title RFPORT RF[FTVF T) BY: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: