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PUTNAM COUNTY HEALTH DEPAR2r utnem YaOey, NY 1057.9
DIVISION OF ENVIRONM UAL HEALTH SERVICES
PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR»
OWNER' S NAME V S ul M d- 2 S d.W (L0 cc) R PHONE 92-6 -'9394
SITE LOCATION I b !, (4,g C4 fZC, TO 7 2 — / -- 2 2
MAILING ADDRESS Q V (K A- Yh �% !� L y , /�• j (0 �dT
PERSON INTERVIEWED PCHD Complaint #
Name & Relationship (i.e, owner,tenant, etc.)
DATE R' 2' L TYPE FACILITY
PROPOSED INSTALLER 60-T P u'T . (o (.L* 13V PHA 5a (b —dg-?S-
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.
'r C N' £Glc 1✓ R IF L �� Ot
bo A -r- c o
ILL
Proposal approv 1"' Proposal Disapproved
Inspector's Signature & Title to
Proposal 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 carponents 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
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 owner, or reported agent of owner agree to the above conditions.
SIGNATURE TITLE J�f 14L� 1 DATE
PISS: Wiite (PAD); YeUcw (fin ffi); Pink (Applicant)
0i1/28/ZO09 11:18 FAX 914 737 0224
JAN -2i °2009 0313PM PROM - ENVIRONMENTAL HEALTH
commusioner ofHealih
COIAM DISTRIBUTORS
0452787021
LN M
T -754 P;002/002 F -817 .
ROBERT J. DOW
County
LORMA MlOUNARY,W WN R B$11 RT MORRIS, PE
Associate Commissioner of Heallie
Director Of Environmental
Heah11
DEPARTMENT OF HEALTH
1 Geneva Road; Brewster, New York 10509
ADDITION MZPCATION SIDENTIAY., ,
STUET 5e - -7 4C.e.- �' �l. '�UWPi�e�T��� 40 %AX MAP. te` �r �• � �.` l�
rr -- _
N'A1bdEtJz.� �.x���>� .t°`�F1t1ONE 1--707-1 ,0..�
MAILING
ADDRESS. 1 c Se')ec, if All
/ [!rY�d ` c
.�DDIITION G`. ,b •'1 . t 4- {-- o� r
NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS
(FROM CERT. OF OCCUPANCY OF CERTIFICATION FROM BUILDING INSPECTOR)
*Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a
Protessio1w Engineer or Registered Architect in accordance with applicable sections of rite Putnam County Sanitary
Code.
Please submit this form and the following to Putnam County health pL., 1 Geneva ltd:, Brewster, NY 10509, .
Phone: (845) 278.6130.
&, Certified Check or mquey order for $100.00.
Sketches of existing floor plan (drawn to scale, all living area induding basement)
3. Two sell of proposed floor plan (drawn to scale — with name, street and tax map #) Non-
professional sketches are acceptable.
A. t~opy .of survey showing well and septic 100ations io the best of your knowledge. Include date al
installation' if know. Label 40 wells and septic systems Within 200 feet or the property lime,
Contact this office with any questions.
/S. Copy of Certificate of Occupancy from .Town or Certification from Building Dept. with legal
bedroom count of dwelling..
OFFICE USE
COMMENTS
BuWnMMenW !L0h (8 ) 371M+113a Fhx (845) _78.7921
Wutar 3aa1P1y Smdoo (845) "..t' S%5186 Fnx (M) M-541d
NiLmiug Selwim (8i5) 276dSSK tilt (dA5) 27* 026 WIC (845) 27"678
14%1LQ Name Cage Fox (K91278.6085
fwdp In►WV4z1doWWWh601 (945) 2W -28x7 r= (x45) 15 -1590
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF- HEALTH
1 Geneva Road,Brewster,,New York 10509
January 30, 2009
ROBERT J. `BOND(
County Executive
ROBERT MORRIS, Pit
Director of Environmental Health
Andrew & Jamie Gottesfeld
16 Seneca Road
Putnam Valley; NY 10579
Re: Letter of No Objection - Gattesfeld
16 Seneca Road
(T) Putnam Valley, T.M. # 62.72 -1 -22
Dear Mr. '& Mrs. Gottesfeld:
In reference to the approved plans submitted to this Department for the above ,referenced
property, (Addition Application No, A- 013 -09) approved on 01/29/09. At this time, this
Department has no objection to the replacement of the.original structure, nor the utilization of the
existing septic, system and well. Separation - distance from the house to the existing system must
kP .m�na�rl��- a�;iaore•o,._.1.1.P1 -mot _morn 'fie h f,:.� ;r. _.k_ • :.•: >. ...
cri= tc -...e �cpti�tu:�.�, �wEr,y-- L-eet��tot�i•- `,
the house foundation to the septic leaching fields.)
If you have any questions, please contact me at (845) 278 - 6130, ext. 2261.
Sincerely,
Gene D. Reed
Senior Engineering Aide
GDR:kly
cc: BI, (T) Putnam Valley
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
a N
SHERLI-TA AMLER, MD, MS, IFAAP
Commissioner of Health
.ORE'T'TA MOLINARI, RN, MSN
Associate Commissioner of Health
January 30, 2009
-Andrew & Jamie Gottesfeld
16 Seneca Road
Putnam Valley, NY 10579
Dear Mr. & Mrs. Gottesfeld:
,DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT, J. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
Re: Addition- Gattesfeld, A- 014 -08
No Increase in Number of Bedrooms
16 Seneca Road
(T) Putnam Valley, T.M. # 62.72 -1 -22
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 January 29, 2009. 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 _
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 proposed changes only. This approval does not validate any
construction shown as existing that has not obtained proper approvals
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 (845) 278 -6130, ext. 2261.
Sincerely,
Gene D. Reed
Senior Engineering Aide
GDR :kly
cc: BI, (T) Putnam Valley
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
Cgmgi1ss1onerofHcalth_ -
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Town Legal Bedroom Count
ROBERT J.', BONDI
Re:_ GOTTESFELD (Owner's Name)
Tax Map #: 62- 72 -1 -22
Address: 16 S en e Rd-
Town:— Putnam Va11ey
Year Built:
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.
This information has been obtained from:
Certificate of Occupancy:
Other: Assessor's Records
uilding 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
Datet -®ber 5 19 95 TOWN OF PUTNAM VALLEY
_ Zone District R -3
- Application is h eby made for
Description
Location of Premises— Street or Roac'
95
PER M,jT EC0R.0__
Commence Work Permit Work to start
Repair Septic
Seneca Road - TM #62.72 -1 -22
SEC: BLOCK LOT FRONTAGE
Depth Rear
ACRES (other description) or number of square feet
SUBDIVISION NAME Abele Park TEL.526 -2356
OWNER Isadore Cooper ADDRESS 16 Seneca Road - Putnam Valley,, N.Y.
Dimension of Building
Width Depth Stories
Type Foundation
Size & Use Each
Room with Window Area
Sewerage Type
Size of Septic Tank
Lineal Ft Drainage
Size of Dry Wells -
Plumbing
Description
'Description
USE
CONST.
ROOFING
LAND _
1 Family
Wood
Wood Shingle
Paved
2 Family
Steel
Asb. Shingle
Dirt
Log Cabin
Brick
Tile
Oiled
Bungalow
Concrete
Metal
Swamp
Apartment
Stone
Brook
Store
FNDTNS.
INTERIOR
Lake F.
Store & Apt.
Stone
Rooms
Dams
Store & Office
Concrete
Apt. Rooms
Sw. Pools
Office
Blocks
Apt.
Ten. Courts
Gas Station
Brick
Attic Open
Garage
Piers
Attic Finished
OTHER BLDGS.
EXT. WALLS
PORCHES
Barns
BASEMENT
Wood
X Front
Shacks
Part
Brick
X Side
Cottages
Full
Brick Van.
X Rear
Bungalows
Cement Floor
Log
X Encl.
Electric
Finished
Shingle
MISC.
Phone
Garage •8. In
Comp.
Plot Plan
..
Furnace
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D�'✓cD:o y. i
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Dimension of Building
Width Depth Stories
Type Foundation
Size & Use Each
Room with Window Area
Sewerage Type
Size of Septic Tank
Lineal Ft Drainage
Size of Dry Wells -
Plumbing
Description
'Description
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�w Fence
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S 52' 04' E I 100.00
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Slate P i io O
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Deck 10000 sq. ft.
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EP
The location of underground. improvements, or
encroachments hereon, if any exist are not
certified or shown.
SENECA R(;AD
Unauthorized alteration or addition to a survey
map bearing a Licensed Land Surveyors seal is -
o violation of Section 7208, Subdivision 2 of
the New York State Education Law.
Only copies from the original of this survey
,narked with an original of the land surveyors's
9mbossed seal shall be considered to be valid
`rue copies.
Richard D.
i:.
R..
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Jordan Jar;! 15 Seneca
Possession only as indicated
1 Richard D. Jordon jr. the surveyor who made this map, doihereby certify
that this survey was completed on Aug. 22, 2004 and this rr,-igp was
completed on Aug. 22, 2004
�l
S. UK NO. UD04U 1. �r
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It 'is hereby certified that this survey was prepared in accordance with the
existing Standards of Practice for land surreys adopted by tits
New York State Association of Professional Land Surveyors. I,'
Certifications indicated hereon shall run only to the persons tar whom the
rLD� survey is prepared, and on their behalf to the title compony", governmental
agency and lending institution listed hereon, and to the assic;4iees of the
lending institution. Certifications are not transferable to addifk,nal institutions
;or subsequent owners.
Certified to Andrew Gottesfeld and Jamie Gottesfeld,
Mid Hudson Valley Federal Credit Union, and
Old Republic National Title Insurance Company. (RG Agency
No. 168 10)
SURVEY OF
PROPERTY PREPARED FOR
ANDREW & JAMIE GOTT 'SFELD
IN THE
`_TOWN OF PUTNAM VA-LEY
PUTNAM COUNTY,,- NEW Y K_
Scale: 1 "= 20'1 "= 20' AUG. 229 L2004
Being Lots 22 and 23 on Modified Map No. �4. iaf
Abele Park, Oscawana Lake,; Filed in the PutnamI-.�• '
County Clerks Office on Aug. 25, 1926 as Map +i�o.
6B
Rd. Putnam Valley, N.Y. 10579
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