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HomeMy WebLinkAbout2884DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.13 -2 -5 BOX 24 ' v . � . i LIE .r- f im Is 61 4 - f L r . oil ' im PUTNAM COUNTY HEALTH DEPARTMENT X DIVISION OF ENVIRONMENTAL HEALTH SERVICES `° .�' yc, .DISFwiAi, SiS!B&W MPA R" OWNER'S NAME ")I (2 S . 5 J� /" w, 1 q zv e- (Y , ►� I1 Q-X . Cl 5 PHONE Cl i U - S�)- ' a -1 SITE LOCATION (u of I �- 140 ,0-6 [20. P Q LAI P M V A LL E-( To MAILING ADDRESS ! a (4 WAS � S h or(�, 1�(- - �i.� 'rtc� M Vo ( tee j N 1-f 1 b :S J- PERSON INTERVIEWED M P- 5 S 1-1 AV,) - O c-u N E-P— - PCHD Canplaint # r �_ Name & Relationship (i.e, owner tenant, etc.) DATE 1 'Z ° (o TYPE FACILITY L e e c -k I .-y c; i 6 PROPOSED INSTALLER Ceti m- crn.cj rno..4 1, '1,1 C)cLj - L n c- PHONE cil K - S Q 6 - :9 7E J REGISTRATION # 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. Lezli i tiq 4 t. L fu b e bu i I i - (�+I ►� i3n s .311E )n 1 s -511 1 q zv e- (Y , ►� I1 Q-X . Cl 5 a ,n C c� Y ,�1 /M 1 - : %Zl V e- 13 0 / � r c {. CA OLI- , LU -- f L e h h �j0 CkA s uf-/ 0 L) A 43 h 6f , 1 f ! .- 7L- 1' ,r5 ✓1 vl o r f f l C%. .._1 :df's Signature & led 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 canponents tied to two fixed points d. System description (e.g., 1250 gal. concrete septic tank, drywells surrounded by one foot + gravel). e. Installer's name and number. MAN Date 3C i( G (21)v (e.g.,house corners). three precast 6' diam. x 6' deep 3. System repair to be performed in accordance with the above proposal and conditions. [, as owner, or reported agent of owner agree to the above conditions. iIGNATURE � 'j'" TITLE 't,/!� ?�aJ�T o(� 16ATE IES: Mite (PCfD) s YeUc w (kin HL): Pink Ugl1csnt) p N 932000 62.09 -1 ----1 Ia Pio 62.10 -1 -5o w 0 (N4 o • 9.00 ��. .2 3 a M 0 CV 4 204.32 LLJ 191 95 -� h . ti t I° cv cc ) y 195.42 cv - S r ® 7 N SIIERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN .'Assoc'iare't.'ommissioner of Neaitli - ° - " " "- ROBERT J. BONDI County Executive ROBERT MORRIS, PE ` '" " "uirecror of Gnvironriientai ti"eaitn ' ` -'� DEPARTMENT OF HEALTH � f 1 Geneva Road. Brewster, New York 10509 ' ` i [ A LF� DDITION APPLICATION RESIDENTIAL ONLY i �...... STREET l cif` SId�Yc��d�J2� l! TOWN_R1LvJQJ1AX MAP # NAME NA ,0) A S J AI M). PHONE PCHD# "J MAILING ADDRESS DESCRIPTION OF ADDITION I, DJIN 6 G I yl176IZD d-M 7� NUMBER OF EXISTING BEDROOMS' off- : PROPOSED# OF BEDROOMS oZ (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 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 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 Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678 Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 =1580 Law Office BOLGER, HINZ & ZUTT, P.C. .. r.O. Box 8 11 Oscawana Lake Road Putnam Valley, New York 10579 (845) 528 -4410 Fax No. (845) 528 -2566 Harold W. Hinz William I Bolger William A. Zutt (1942 -2006) November 30, 2011 Putnam County Health Department 1 Geneva Road Brewster, NY 10509 RE: 124 West Shore Drive Putnam Valley, NY Dear Sir/Madam, I am the attorney for the Estate of Nadia Shaw and am trying to obtain Board of Health approval for an enclosed sunporch/living room which was added to the house possibly in the 60's. Enclosed is the application, sketches, survey and bedroom count from the Putnam Valley building department, together with a check for $100.00 We are attempting to close on the sale of this house before Christmas so anything that can be done to expedite this would be greatly appreciated. As the house is vacant, please address all correspondence to me at the above address and if we need to talk, please call meat (845) 528 -4410. Thank you. Very truly yours, 2BO R, HINZ ZUTT, P.C. !/�' OLD . Z ES Q. Q w o oommmmommmiommmmm � � 00000000000000000W�m K' a iaiiiiiiiiiiiiiiiiiiiiiiMI MEMMMMMEMEMMMMMMMMENEomm MMMMMMMMMMMMMMMMMMMMMMMMM ..........■...I..■........ iiiiiiaii°Miisiiiiiiiiiiii MMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMM iiiiiiiiiiiiiiiiiiiiiiiiii MMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMM ----M--------------------- � ®e MOMEMN MEMOME i W MMMMMMM MM MM ........................i. MMMMMMMMMMMMMMMMMMMMMMMMs■ MMMMMMMMMMMMMMMMMMMMMMMMM■ MMMMMMMMMMMMMMMM ■MMMMMMMM■ MMMMMMMMMMMMMMMMMMMMMMMMM °' MMMMMM iiiiiiiiiiiiMMMMM Basement Floor Plan MMMMMMMMUMOMMMMMMMMM MMMMMMMMMEN, j REBECCA W111KNBERG, RN, BSN Public Health Director ROBERT MORRIS, PE i6l'.:._� ... December .13, 2011 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Nadia Shaw 124 West Shore Drive Putnam Valley, NY 10579 Dear Ms. Shaw: Re: Addition- A- 155 -11 MARYELLEN ODELL County Executive No Increase in Number of Bedrooms 124 West Shore Drive (T) Putnam Valley, T.M. 62.13 -2 -5 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 13, 2011. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at two 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. _4., Th s- Dep a(rocommends y 0 u contact 'Cur loc.^.: `�- I ; Young _Adult /2. `, Reeves ' Conservation ® r; / Pond Corps ' e �s ; s y . ')c1 °"�!• 'rr_'7 d��qn ] ^ � J 4�u +! i X As a c f 3f D..�� �7f F�ikY1n81Ts 0�1 J /: v LDg 3E �i ® � r RD 20 � _ q SW TR < Q° TE I RD ce / / t N 0 HILL 11\N TH un ,yam ¢ 1 vY UAC14 WA HUDSON VIEW pt s 3 3 �a •�• $ PDPy-. S N SMR NEW t 74 I \ \ g D O" DR ( i .. .. .: ...:... r..... ._:?.._... —_. ` .a �.:d� (a�g 20 SP r /" f✓ 9' o 1057'; 0 H 11 (�� Byovl ° ON�RCH (� I 1: IA d m LA •O a RRi RD E_ (� m 1 RD 4 s p w W Q °o\ S a KRAMERS RD O PUT IAM V LEY r ous useum1 ;1 TIN ST RD ose Hill Park Town Park j� Cem Cem u 1 Q53 Cem r 1 9n _ 1�4 cc Existing Floor Plan-First Floor I I I I I ,I/,Z , Putnam Valley, NY 10579 TM# 62.13-2-5 +++ Name: SHAW A) 1 = 2 feet 01 34 feet 11 2.feet I I I I I I I I I I I I I I I I I I I 1 1 121 feet I I I I I I I I I I I I Stairs to basement descend from right to left I I 110 feet I I 40 feet 1 Square = 2 feet ,HERLITA ANILER, MD9 MS, FAAP Commissioner. of Health LORETTAMOLINARi,RNvMSN. - - Associaie Commissioner of Health ROBERT J. BONDI .County Executive :CBE.L. INIGRRiS,. Director ofEnvironmental Health DEPARTMENT OF HEALTH I Geneva Road. Brewster, New York 10509 Town Legal Bedroom Count & Proposed Addition Status Re: SHAW (Owner's Name) Tax Map # 62.13-295 . Address: 124 .West. Shore Drive Town: Putnam Valley Year Built:. 1950 According to records maintained by the Town, the above noted dwelling, is . XX in compliance with Town Code. Is not in compliance with 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: New Construction XX Addition to existing house only Teardown and /or re -build allowed under Town Regulations B. j .. g Inspector ...John H. Landi Date 6. ' 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 44 It. Fx ,4110-5 L -g lc� irsc 11 Iq Naw ,Z,41YCi5 O 'I IL O