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HomeMy WebLinkAbout3240DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73. -1 -27 BOX 26 Wr lrb i . 03240 ` PUTNAM COUNTY DEPARTM&Y OF HEALTH f Division of Environmental Health Services, Carmel, N. Y. 10512 , ONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM t�L? } 7b -" —Town or Village` ' oeated" at rri t'2C, : Lw76+Lp Ih D - R Section Block 1 r �1 i2G 14"L4- Lot �h Job ubdivision g elaff [7 wrier S rA.,J w L,0 D 43u i -L IWA S' /.v C Address IR t o-c i jiLL. uilding Type Ref. Lot Area umber of Bedrooms Total Habitable Space %� ©O Square Feet iparate Sewerage System to consist of /2- Gal. Septic Tank Y'/0 lineal feet X 3 width trench be constructed by ����` Address i ster Supply: Public Supply From + Private Supply to be drilled by AJ` AN Aemio Ala l+ Address - ?V YN A,4 V L.t C her Requirements ipresent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system ive described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules an regulations o e u nam inty Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Health will submitted to the Department, and a written guarantee will be furnished the owner, his successors, heirs or assigns by the builder, that said builder will :e in good operating condition any part of said sewage disposal system during the period of two (2) years Immediately following the date of the issu- e of the approval of the Certificate of Construction Compliance of e j anal syst any repairs thereto; 2) Yhat the drilled well described above be located as shown on the approved plan and that said well will be insta ed I ccorda ce h the standards, rules and regu a ions of the Putnam inty Department of Health. a Signed P,E, R.A. Address License No. ROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is cable for .cause or may be amended or modified when considered necessary by the Co mmi of Health. Any change or alteration of construction ,ires a new permit. Approved Apprroved for disposal of domestic u ar e r p a upply only. i A_ a , By Title 1 PUTNAM COUNTY, DERARTMENT-OF= ,HkAIT'H-` Division of Environmental Health Services, Carmel, N. Y. 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM N" VNu l Town or Village Section c Located at Block Owner Lot Job Separate Sewerage System built by Address 2 Consisting of ^a —Gal. Septic Tank lineal Feet X 7 width trench � Other requirements 2J Water Supply: Public Supply From Private Sum` Drilled By r r`� D`-i' "�^" ress Building Type I - -- Has Erosion Control Been Completed? No. of Bedrooms I certify that the system(s) as listed serving the above premises were constructed attached), and in accordance with the standards, rules and regulations, Date Address Date Permit Issued 1 q �s of the completed work (copies of which are the Putnam County Department of Health: r.. — R P.E17��t�Z .i Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a public sanitary sewer becomes, available and the approval of the private water supply shall become null and void when a public waters ly becomes available. Such approvals are-, .: subject to modification or change when, in the judgment of the Co iss e7pf Health, such revo9dfioqJ modification or change is necessary, s a;� ct r � , • J t V L ( 9 rt t PEEKSKILL MEDICAL, LABORATORY'' 1879 Crotnpond Rd. Barclay P16za'.Bld'g. A; 'Apt 1 Peekskill, New York 1056,6 ti pE 7-8777 '�1 r ,.. ,. DATE COLLECT : RESULTS OF EXAMINATION OF WATER . r d' )WN ER - DATE RECEIVED _ "n a . ITY. VILLAGE, TOWN 6 /OR NAME OF SUPPLY :. DATE REPORTED AMPLING POINT �. ,r ACTERIA PER ML. (Agar.plate cqunt at 35 C). COLIFORM GR,OU�,1P (Most probable No. /looml.) RDNESS, TOTAL -ppm. ETERGENTS - ppm NITRATES (as N) - ppm IRON, TOTAL - ppm . OURIDE (F) - mg. /1. hese results indicate t hat'the water wt7s of a satisfactory sanitary quality when the sample was collected 9 1 / t ; ` T. (ASCP) • A H PADOVANi, �t � -1. \` t (zip•:) .'. � y - ❑ _ Tf ct J t; LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 ROBERT J. BOND) Cb� Fdy Executive Eavireninental Health (845)278-6130 Fax(845)278-7921 Nursing Services (845) 278 - 6SS9 WIC (945) 278 - 6678 Fax (W) 278 - 6095 Early lutmendonlPresche.91 (845) 278 - 6014 Fax (845) 278 - 6648 T June 29, 2004 Somnicr,- 9 Birch Hill Road Putnam Valley, NY 10579 Re: Addition' Sommer, Birch Hill Rd.: No Increase in Number of Bedroorfl,s M Putnam Valley, TM#73-1-27 Dear Mr. Sommer: 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 June 28, 2004. The addition is approved with the following conditions. 1. The total number of bedrooms must remain at four without prior approval by this 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., now low flush toilets, restrictors for shower heads and faucets, etc. Any 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. Sincerely, Michael Luke ML:hn Public Health Sanitarian cc: BI (T) Putnam Valley I PUTNAM COUNTY DUARTMENT OF HEALTH YX DIVISION. OF FNVT.F;OL`) 1ENTAL L LES DateCsG Re: Property of Sy"ANZ- 1/00.2 ­wc Located at • &Acll 11iGG Section Block Lot _:s Gentlemen: This letter is to authorize /WrJGLrq.y _,gzirr a duly licensed professional engineer or registered architect (Indicate) to apply.for a Construction Permit for a separate sewage system; to + serve the above noted property in accordance with the standards, rules or regulations as promulagated by the'Commissioner of the Putnam.Coutty Department of Health, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 1.47, Education Law, the Public Health - Law,, and , the Putnam .County_ „Sani -. tary Code. / .r Countersignw: P.E., R.A., Address Telephone Very truly yours, Signed - 5�hAJWao /�llrcv�s�J l� C, er of Pr ty Addr ss 5y-r -3d y Telephone c Owner or Purchaser o Buil ing Municipality Building Constructed by Section Location - Street Block Building Type Lot GUARANTY OF SEPARATE:SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of� the sewage disposal system serving the above described property, and that it has been constructed as•shown'on the approved plan or approved amendment thereto, and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guaranty to the owner, his succes- sors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of initial use of the sewage disposal system, or any repairs :made by me to such system, except. where' the failure to operate properly is caused by the willful or negligent act of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de- termination of the Director of the Division of Environmental Health Ser- vices of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this day 19 =� Signat Title - I or ation, giv e and a e e - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam .County Department of Health ..c ..a - ... �. ....... u .._. .. ... .. _ . - iii _ —.. _.... . •'. r.:, ..�. _ BRUCE R. FOLEY Public Health Director �pd Arl LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (845) 278 - 6130 Fax (845) 278 - 792 "1 Nursing Services (845) 278 -.6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervcntion (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 3 .Ffi.. ADDITION APPLICATION (RESIDENTIAL ONLY) STREE� i r< H H l LC � O TOWN AV TX MAPir 7 3" 1- D "e$"PHONE FV S- t/r'lY_gZ4/0PCHD9 4 -- I I' % `O I MAILI\TG ADDRESS DESCRIPTION OF ADDITIONS e\A 1 \TL\,MER OF EXISTING BEDROOMS__�f ­PROPOSED. # OF BEDROOMS 0 (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prep red, 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 Road, Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money &der fof $100.00. 2. Sketches of existing floor plan (drawn to scale, all living area including basement) *Non- professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map 9) *Non - professional sketches are acceptable. 4. 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. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE Comments Feb98 BFhoaseguidetines d E .'BRUCE R. FOLEY Public Health Director LORETTA MOLINARI RN., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 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 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: Re: SbtA1AVZ. Residence Tax Ma 3 — 1- 2-i Town UI-N AWl AL-L 1-1 According to records maintained by the Town, the above noted dwelling IS NOT in compliance with Town code and the total number of bedrooms on record is `"t This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: l` OTHER Building Inspector BFhouseguidelines PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512. DESIGN DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner kguojooD Address �'� ax 13 S l ee v R.uy 2 b Located at (Street) 194H F1ict D Sec. Block Lot (Indicate neares cross street) Municipality PU , A/A M I/A"C, Y Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run apse Depth to Water a er ve No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 2 3 2> \ 3 9 1 Z 2 4��� Z_, 4 -ZAo �3 l 7so 4 41, �,0 4 .W -2- 2 3 \ 3 9 1 Z Vo Z_, 4 -ZAo �3 l 7so 5 3 4 0 Notes: 1) Tests to be repeated at same depth until approximatelyy equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO_BErSUBMITTED WITH APPLICATION -- ={DESCRIPTION OF SOILS ElNEE)UTNTE!RtD- IN TEST= HO.U— DEPTH HOLE NO. HOLE NO. HOLE NO. G.L. ill. 6" sir'` 12" 18" 24" 30' 36" 4011 48" 5411 60" .. V11 781 8)+" u =- ZD_TCATE LEVEL AT WHICH GROUND WATER IS- ENCOUNTERED'= :' INDICATE LEVEL TO WHICH WATER LEVEL'RISES AFTER BEING ENCOUNTERED 'PESTS MADE BY Date - DESIGN Soil Rate. jJsed Mii`i/1 "Drop:, S.D. Usable Area Provided .No. of Bedrooms �r� 'Septid Tank Capacity /Z� Absorption Area Provided By .� L. F. x2�+" �e t t11, trench. Name �1 U�43 nn A �ignaturer . Addre s s Q..!CL'� .� L. • dub S ; L rti THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq...Ft /Cal. Checked by Date 90 -/3: - /0236 (") TO: CARO L S. RAPPORT SOMMER ,30MMER AND ORTGA 5 E CORP., C - L_-)'q E AND ABS %RR E WITH Ti,,E EXISTING CODE OF PRACTICE FEYS ADOPTED BY THE NEW YORK STATE DF PROFESSIONAL LAND SURVEYORS. i�_OVRE UN To THOSE INDIVIDUALS STONE < ONLY N 4EREON UNDER THE TITLE ARE POLICY NOT SAID CERTIFICATIONS 'VN HEREON BE //VCi LOT ,3 `6418D /V 1S 10n1 MAP OF eCT /pN /'I. 5'A ID MAPFILED COUNTY CLERK'S OFF /CE '3 AS AoAP /lo. /3/7. "d for the map and copies �oP­ bear the impressed e 119na1ure ppears neseon tk PREPARED BY ASSOCIATES �VRVEYORS cIELDS LANE r, O A LOT 3 AREA SURVEY OF PP0PE"RTY .SITUATE /N THE ,. , 4 A 5 . TQWN OF )C/TM4M 1�AL L EY =66,406 S. F, PUT/VA M COUNTY Unauthorized alteration or addition to a survey NEW YORK mop bearing a licensed land surveyor's seal is a violation of Section 7209, subdivision 2, of SCALE: /" =40' DATE: FER. /, 1991 the New York State Education Low The location of underground improvements or encroachments, if any exist,ore not certified A, �-1 i NO TR UCKS"MACHINERY,BUILDING MATERIALS NOR EXCAVATED EARTH SHALL BE ALLOWED 14' THE SEWAGE DISPOSAL AREA. CONSTRUCTION. OF THE SYSTEM IS TO BE IN,trkCORDANCE WITH THESE PLANS ANY REVISIONS THERETO AND THE RULES ANI),NEGULATIONS OF THE PERMIT ISSUING GOVERNMENTAL AGENCY. 1 ii 4,k m SEPARATE SEWERAGE YS;EM'2�1 OWNER: LOCATION: )SEC. ---�BLK. iLO CONTRACTOR: DOLPH , ROTFELD ASSOCIATES DoLpi AS BUILT I'LAN:--7-/ f-512 MAMARONECK AVENUE WHITE PLAINS,NY Ix NO TR UCKS"MACHINERY,BUILDING MATERIALS NOR EXCAVATED EARTH SHALL BE ALLOWED 14' THE SEWAGE DISPOSAL AREA. CONSTRUCTION. OF THE SYSTEM IS TO BE IN,trkCORDANCE WITH THESE PLANS ANY REVISIONS THERETO AND THE RULES ANI),NEGULATIONS OF THE PERMIT ISSUING GOVERNMENTAL AGENCY. 1 ii 4,k m SEPARATE SEWERAGE YS;EM'2�1 OWNER: LOCATION: )SEC. ---�BLK. iLO CONTRACTOR: DOLPH , ROTFELD ASSOCIATES DoLpi AS BUILT I'LAN:--7-/ f-512 MAMARONECK AVENUE WHITE PLAINS,NY