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Home My WebLink About3103DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.71 -1 -14 BOX 25 .. a 1 11 ,LL r , 66 ■ ; I oil 03103 SITE LOCATION OWNER'S NAM] MAILING ADDR PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FORrSEWAGE DISPOSAL SYSTI✓1VI REPAIR' ..._. ; " OFFICIAL USE ONLY PERSON INTERVIEWED PCHD Complaint # a ne & Relationship i.e., owner, tenant, etc. DA PROPOSED INST. ADDRESS TYPE FACILITY PHONE REGISTRATION# Proposal (incldde 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. I; as owner; or r SIGNA owner agree, to the conditions stated on this -forts. r TITLES DATE 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. i 3-- System repair to be performed in accordance with the above proposal and conditions. Proposalapproved_ Inspector's Signature & Title COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML / l/: �- DATE fia, MEMORY TRANSMISSION REPORT „_AECz062010- • -04:.31 PM TEL NUMBER 8452787921 - NAME ENVIRONMENTAL HEALTH FILE NUMBER : 612 DATE DEC -06 04:30PM TO 817186243130 DOCUMENT PAGES . 008 START TIME DEC -06 04:30PM END TIME DEC -06 04:31PM SENT PAGES . 008 STATUS OK FILE NUMBER 612 * ** SUCCESSFUL TX NOT ICE * ** PUTNAM COUNTY w>; sr _TH DEPARTZVIEN i' �•Z .y L7TiiISION OF ENVIit.ONMENTAI.. fIY:AY -TfI SE32'VICES � ' � Pl'tOPOCAY FOR S7E��AC'E DTSPOB�„ �},'Q'SEM 1ZpA7R orFlclwt.. vse olvav SITE I.00A'rION 744 OWNER'S NAME PHONE MAII.ING� t�UDTZESS PERSON INTERVLERrED PCIID Complaint # ame at 1A.Clationsmp .e_, owraer, tenant. etc. DATE TYPE FACII..ITY = •�I�'P- OSED:.II�i.Sx - PHONE ��.� ADDRESS REGISTRATION# ' Pr pasal (lncl de slcotcu Iocating all adjacent vvells>: NOTE: Repair must be in same location and of same type as original sewage disposal system _Di$brent location may require submittal of proposal from licensed professional engineer or registered architect. i ii.s JAY /� 2c � S' - .v�o�� . �'.P- � c� �l /`.r! � �o��i..s�• S G I, as owner, or rted agent of owner agree to the conditions stated on this form. - -, -<!n -2 v Lo I . Procurement of any Towa permit, if app 'cable. 2. Submission of as built repair sketch in dupligate showing= a_ Owner's name b. Site Street Name, Town and Tax Map number. V. Location of installed components tied to two fixed points (e.g.,house corners_ d. System description (e.g., 125o gal. Concrete septic tank, three precast 6' diem. X 6' deep e. Installers' name and number. 3e System repair to be perFormed in accordance with the above proposal and conditions. Proposal approved h� Inspector's Signature 8c Title DATE COPmS-- Whim (Town 1913; Pink Cnpplia * PC -RP 991va. BRUCE -'* R. FQL - Public Health Director - - LORETTA . MOLRi �L R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF BEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 WIC (914) 278 6678 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648 April 12, 2000 Jeffery Coren 225 West 34th St. Suite 1900 NY NY 10122 Re: Addition- Coren - Shawnee Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 62.71 -1 -14 Dear Mr. Coren: 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 form this Department dated April 12, 2000, he addition is approved with the following conditions: I._._. 1.- N 3 The-total number of bedrooms roust remain atjyj without pfior approval by this department. The area of the existing sewage disposal system, and its expansion area, must be maintained. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Very truly , William Hedges WH:kg Senior Public Health Sanitarian CC:BI Y •fit. - `.. i l —� -o x_." y�l•�of � i PUTNAM COUNTY DEPARTMENT OF HEALTH wil.l,�sE HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY; t� i —;Z6EDROOIAS Signature 8 Title e r !I: :i S �t uIi LDJFIOVA v6ED A t. e-17 I _qol f -*F ; Fj -4 II �1, cao4v� -nao TNAM COUNTY DEPAT MENT OF HFAN PLANS APPROVED FOR )M COUNT ONLY, -DROOMS -e & Title v6ED A t. e-17 I _qol f -*F ; Fj -4 II �1, cao4v� -nao Wkw 6-fAwa,- 3� jlPe, FeaP4 4jpi--jjj.aF- f-f- 4ft,23VAl L-P�- t y. 1 rM �o 5 oL vi 3 <c w wv,I o- 3 � s rM �o 5 oL vi jae wv,I Ll fr i rM �o 5 oL vi . .. �-t HIV tO . r„ ,;-2i �r-- 4 rFo" 'T"OUAS A. :!OEM" ARCHITECT ' TOAVSIWR K W,AC.KY.10341 (QW-128-7498 SITE LOCATION OWNER'S NAM] MAILING ADDR PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PR ®P ®SAL FOR SEWAGE DISPOSAL SYSTEM aPAgIB � OFFICIAL USE ONLY PERSON INTERVIEWED PCHD Complaint #. ame a ations ip i.e., owner, tenant, etc. DA WE TYPE FACILITY PHONE c��l . [RATION# Proposal (lncldde 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 I,ss o.v�riier; t° orted_ agent: of owner. agree _to the conditions_. stated on this form-, SIGNA TITLES - DATE 0 /�/ 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 corners). d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep e. Installers' name and number. i 3,- System repair to be performed in accordance with the above proposal and conditions. Proposal approved Inspector's Signature & Title COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99M L DATE 6kUCE R. FOLEY _.a. Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York '10509 � ¢ ,h ✓VJ 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 Fax(845)278-6648 Preschool (845)228-5912 Fax(845)228-6113 Jeffrey CoreAr l 34 Shawnee Rd. Putnam Valley, NY 10579 Dear Mr. Corea: December 21, 2001 Re: Addition - Corte 34 Shawnee Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 62.71 -1 -14 I have received and reviewed the plans for the proposed replacement. to the above - mentioned residence destroyed by fire.. The proposal for the replacement has been approved as per plans bearing the approval stamp form this Department dated December 20; 2001 The addition is approved with the following conditions: I. The total number of bedrooms must remain at Two without prior approval by this department. the. - fisting sewage disposahsystem; and its expansion rarea, rnust bd 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. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Very trul . rs, William Hedges WH:kg Senior Public Health Sanitarian cc: BI is � me-jvlaj L �j fin vn.n I�w Ll:�w F 4Ti FROM THOMAS A NUGENT ARCHITECT PHONE NO. : 914 628 7495 Feb. 18 2000 03:36PM P4 FoiEY �a 9 Ju=alth Director g DEPARTNENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 rel. (914) 278.6130 Fax (914) 278 - 7921 ':•'• • � ••1111 •� .. _ • �.' •:_.. � /_._ _ +�� STREET � M i� � ale e - TOWN PJrUAN OWI, TX MAP # 6 J -9 P — /- y He'"If-G'e -r Pom ►.1A1=NT NM, E_ J (fo le 15-1 PHONE- PCHD # -06r MAILING ADDRESS e_�� 3 �(` Sfi l"y ®� lJtL-t Al 1� /,01 V-1- DESCRIPTION OF ADDITION N70 Fle'r-4'I&I, 2Nlo Ft,. Ato mete 1 wiry or�� 13�tDt�d -t i9riLrTE£ f3P 69g V M ON I d'r "(2 NUMBER OF EXIS'g'XNG BEDROOMS PROPOSED # OF BEDROOM S-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 Putnam County Health Dept., 4 Geneva Rd., Brewster, NY 10509, Phone 278 -6130. /1. Certified check or money order for $100.00 k . Sketches of existing floor plan (drawn to scale, all Hiving area including lbasement) * Non - professional sketches are acceptable 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #) Non- professional sketches are acceptable . 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. t� Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE I1,SE Comments Feb 98' y_ CAF_ A- 9- Co BRUCE R. FOLEY, R.S g Public Health D Actin Ith rector i DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 3',�5 /aco0 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: 3 Residence Tax Map 62. '7/-- / Town Gentlemen: According to record maintained by the Tom, the above noted dwelling is IS NOT in compliance with To�Nm code and the total number of bedrooms on record is ems. This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER • S d -' `z Building Inspector w SURVEYED & PREPARED BY - .ALgXANDER BUNNEY_ LAND SURVEYOR. P.C... 20 WOODSBRIDGE ROAD ROUTE 117 KATONAH. NEW YORK 10536 •,N. Y. S. LIC. No. 26694 a�w.on ciinnu .• � . - - -- 4F N s p e.EAll.SES .SHONV/N HE 2 E0/Y 6E 11YG LOT /YO. 96, .SAME AS .5N0YV/V O/Y 'W00 1/f /E0 MAP NO•R OF,4BEGE P J,4 /p MA.O F/LEO /N THE COUNTY CL Oi'F /CE 0" .4416 RS, /F26 .45' M,4A / J UP VE K OF .,0.4q C TY P.eEPA.L�E,D /F0�2. TO Off' YeXL i�U 7 ,^1A" CO C//V 7 NEYV YO�� SURVEYED AS IN-POSSESSION D.4 7jE7 : 0c7— al/k, /5 Col- of FILE NO. 7 % i 1//C7-0.e Ir CL.4 1.eE V . J ,LOT /1/O. 7B LOT NO. 77 -5 Tz.04'E S, 000 1,— 2.0 •.. ?p�c�c b = O. //.5 AG S MI , • W I,OGATIDN s � s � p o• .W Z UN N o i Q ; 1 �NFLLL v .0A-r /0 Y z t I woo o e y I v--c . ^t p.60 w SURVEYED & PREPARED BY - .ALgXANDER BUNNEY_ LAND SURVEYOR. P.C... 20 WOODSBRIDGE ROAD ROUTE 117 KATONAH. NEW YORK 10536 •,N. Y. S. LIC. No. 26694 a�w.on ciinnu .• � . - - -- 4F N s p e.EAll.SES .SHONV/N HE 2 E0/Y 6E 11YG LOT /YO. 96, .SAME AS .5N0YV/V O/Y 'W00 1/f /E0 MAP NO•R OF,4BEGE P J,4 /p MA.O F/LEO /N THE COUNTY CL Oi'F /CE 0" .4416 RS, /F26 .45' M,4A / J UP VE K OF .,0.4q C TY P.eEPA.L�E,D /F0�2. TO Off' YeXL i�U 7 ,^1A" CO C//V 7 NEYV YO�� SURVEYED AS IN-POSSESSION D.4 7jE7 : 0c7— al/k, /5 Col- of FILE NO. 7 % /4.29 d W V . J �� 4 s � h h � p o• o i Q ; 1 �NFLLL v .0A-r /0 Y >\ o e •r /. 5o' U . •'LONG. Bea WALL•• �•••�60 w SURVEYED & PREPARED BY - .ALgXANDER BUNNEY_ LAND SURVEYOR. P.C... 20 WOODSBRIDGE ROAD ROUTE 117 KATONAH. NEW YORK 10536 •,N. Y. S. LIC. No. 26694 a�w.on ciinnu .• � . - - -- 4F N s p e.EAll.SES .SHONV/N HE 2 E0/Y 6E 11YG LOT /YO. 96, .SAME AS .5N0YV/V O/Y 'W00 1/f /E0 MAP NO•R OF,4BEGE P J,4 /p MA.O F/LEO /N THE COUNTY CL Oi'F /CE 0" .4416 RS, /F26 .45' M,4A / J UP VE K OF .,0.4q C TY P.eEPA.L�E,D /F0�2. TO Off' YeXL i�U 7 ,^1A" CO C//V 7 NEYV YO�� SURVEYED AS IN-POSSESSION D.4 7jE7 : 0c7— al/k, /5 Col- of FILE NO. 7 % IS WELL SITE SUBJECT TO FLOODING ?. YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME .OF SUBDIVISION: M ,'40 M� c,2_4 A6 LOT NO _ : 97 F_M. 63 d4 WATER WELL CONTRACTOR: Name 0- AplDESoN Address: {'MWP4*\ • \PALtf -� IJy, IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES v" NO NAME OF PUBLIC•WATER SUPPLY: TOWN /V /C DISTANCE .TO: PROPERTY FROM NEAREST. ,WATER .MAIN l),fl SY- E.1,0;H, —&--S "u zCE' S: GF- C0V;7�A 'iINATION_" .s c i i. i .: a v L 1 'V (date) (signature) PERMIT - TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction., the applicant shall: 1. Pump the wel -1 until the water is clear. 2. Disinfect the,iwell in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a We 1 Completion Report on a form provid d by the Putnam ounty Health epar Date of Issue: 19 P rmit Iss 'Official Permit is Non - Transferrable STREH IUWN /VILLAGEICIVY 1AX GRiu NUMBER. WELL LOCATION q1 Slti� 1"Z�,_ Pw�n Ua��1e S1 - 3 -23 WELL OWNER NAME. • Motion 1.%k4:111t Corcv� ADDRESS: 9� S1,�wmt �_ P,�,r., U..il 9 PSIVATC ❑ PUBLIC USE OF WELL O RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED 1 - primary ❑ BUSINESS ❑ FARM ❑TEST /OBSERVATION ❑ OTHER (specify) 2 -secondary ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ AMOUNT OF USE YIELD SOUGHT 0_g Sc gpm. /N0. PEOPLE SERVED 2 / EST. OF DAILY USAGE vo gal. REASON FOR 9 NEW SUPPLY ;4t) ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION GRILLING� REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL WELL TYPE DRILLED DRIVEN DUG GRAVEL ❑ OTHER IS WELL SITE SUBJECT TO FLOODING ?. YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME .OF SUBDIVISION: M ,'40 M� c,2_4 A6 LOT NO _ : 97 F_M. 63 d4 WATER WELL CONTRACTOR: Name 0- AplDESoN Address: {'MWP4*\ • \PALtf -� IJy, IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES v" NO NAME OF PUBLIC•WATER SUPPLY: TOWN /V /C DISTANCE .TO: PROPERTY FROM NEAREST. ,WATER .MAIN l),fl SY- E.1,0;H, —&--S "u zCE' S: GF- C0V;7�A 'iINATION_" .s c i i. i .: a v L 1 'V (date) (signature) PERMIT - TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction., the applicant shall: 1. Pump the wel -1 until the water is clear. 2. Disinfect the,iwell in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a We 1 Completion Report on a form provid d by the Putnam ounty Health epar Date of Issue: 19 P rmit Iss 'Official Permit is Non - Transferrable •County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services August 5, 1986 Morton & Lucille Coren 97 Shawnee Road Putnam Valley, New York. 10579 Re: Well Permit #W-8-86 97 Shawnee Road Town of Putnam Valley Dear Mr. & Mrs. Coren: Forwarded.herewith is a permit to drill a well on the above captioned property for potable purposes. You will note that the permit is to drill the well only and is issued for one year. Approval to place the well in service will be granted upon receipt of the following: rilp I �r = �� pr 2. Result of Bacteriological Analysis. If you have any questions, please contact me at ext. 241. Ver trt ly yours, JY.h'n Karell, Jr., P.E. Director Environmental Health Services JK:cj cc: Building Inspector File / TWO. COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641