HomeMy WebLinkAbout2961DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
62.17 -1 -63
BOX 25
02961
Im
Ir
1
1.6
r
i In so
194
r
No
02961
ALLEN BEALS, M.D., J.D.
Commissioner of Health
:RODER "i,�.MORRIS
Director of Environmental Health
MARYELLEN ODELL
County Executive
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 1 0509
Phone # (845) 808 -1390
. Fax # (845) 278 -7921
Daniel Hausler
17 West Shore Drive
Putnam Valley, NY 10579
Re: Addition — A- 085 -12
June 8, 2012
No Increase in Number of Bedrooms
17 West Shore Drive
(T) Putnam Valley, T.M. 62.17 -1 -63
Dear Mr. Hausler:
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 June 7, 2012. The addition is approved with the
following conditions:
1. The total number of bedrooms must remain at three without prior approval by this
Department.
Arez_- ofthe;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 June 7, 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
]REBECCA WITT'ENBERG, RN, BSN
Public Health Director
ROBERT MORRIS, PE
Director of Environmental Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10,509
Phonle # (W) 808 -1390
Fax # (845) 278 -7921
ADDITION APPLICATION RESIDENTIAL ONLY
MARYELLEN ®County Execve
STREET 17 / *e L1,-_TOMWWN TAX MAP #62,17--
l
NAME !" GtLer PHON %G% `Xa _PCHD# e�} -'�'g� '( °Z
MAILING / /
ADDRESS / ° � Gr Ve-- /J/ 1P)W 44,, Y -
DESCRIPTION O /J 4��v �`��,
ADDITION r I �`
*NUMBER OF EXISTING BEDROOMS NUMBER OF PROPOSED NEW 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, Y
Brew�ter, NY 10509, Phone: (845) 808 -1390.
✓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
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
4.
1
REBECCA W TENBERG, RN, BSN
Ablic Health Director
ROBERT MORRIS, PE
Director of Environmental Health
MARYELLEN ODELL
County Executive
.. . -♦C•'< • ...r{nc r. ...« � C � � .. �O'�M -�. .M:.<lT -�Y �V.v.. r_. ...
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390
Fax # (845) 278 -7921
Town Legal Bedroom Count & Proposed Addition Status
Re: Hausler (Owner's Name)
Tax Map# 62.17 -1 -63
Address: 17 West SY�ore live
Town: Putnam Valley
Year Built: 1960
According to records maintained by the Town, the above noted dwelling,
is xx in compliance with Town Code.
- IS—,not -_ __._.in- compliance-4ith
The Legal Bedroom Count is: 3
This information has been obtained from:
Certificate of Occupancy:
Other: Building and A sessor'G Files
The plans for the proposed addition are considered:
XX Addition to existing house only
Teardown and/or re -build allowed under Town Regulations
Z�tffing Inspector
5.
Date
6/1/12
Y
OWNE
SITE
MAILING ADDRESS
-.` V .7�"
V M nz7v,
®MW_
PHONE -,o k� �4 `7
Tm# l.1, (7 - 1 -
PERSON INTERVIEWED PCHD Complaint #
& Relationship (ice, owner,tenant, etc.) M 1""M - 1�,��j
DATE Z TYPE FACILITY �? v:->
PROPOSED INSTALLER f� 'U l%r " PHONE j�2- � ¢ )s Cl -r
Pro (include sketch locating all adjacent wells) :
MOTE: 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.
Proposal approved
Inspector's gignature &
Proposal Disapproved
Date
with the following conditions:
1. Procurement of any Town permit, if applicable.
20 Submission of as built repair sketch in duplicate showing:
ao Owner's name
bo Site Street Dame, Town and Tax Map number.
co Location of installed components tied to two fixed points (eogo,house corners).
do System description (e.g., 1250 gale concrete septic tank, three precast 61 diem. x 61 deep
drywells surrounded by one foot + gravel).
eo Installer °s name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
I, as own
SIGMA
or reported ag
t of owner agree
to the above conditions.
TITLE -� ATE
QIUS: ftte MV; a Yel.lcw (T:kn Ea:),- Pink (Applicant)
P, T S 4CU F_ o
��7 � 6 y
N9 "-4899'
At -:'� -FOR
mp. ...........................
4-<f- 05e4wdMf
Pv-r V-4(,,LC�
Rear...........................
t............ * ....... * ..........
Ui<_ ....................
Building
s-f
3r6'