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HomeMy WebLinkAbout3305DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdoes.com 631- 589 -8100 73.05 -1 -27 BOX 27 L A 1'6 101 03305 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES ::°' --AJ if0 SAiCTO SMAGE-DISPOSALSYS t'l i l z�► � �, ..; ,,. :....,,v ��. , :- SITE LOCATION OWNER'S NAME _ MAILING ADDRESS OFFICIAL USE ONLY R-3,11)7-0 .� TM# '?�A ( s fl PHONE iitfs-, GU — '. T Z 1 0-"9 PERSON INTERVIEWED PCHD Complaint # Name & Relationship i.e., owner, tenant, etc. DATE a I -.-e PROPOSED INSTALLER "tl ADDRESS - q c C4'u-4" R-Qk 1 v *4a TYPE FACILITY PHONE IRATION# (3 Proposal (include sketch locating all adjacent wells): (a 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. 0 L a ��r- gu t --) r— 1 4-5-,-1 A I AJ e C. Z (O 6 0 64-L � -i� C O,G �`6' - Gik'c l <_ TLkVzk/44 - -?;Ir&i f c.q,L, 05'— S� Atl` 4@..€A 1--n cA -ftdW, P- d— 'f'd�csr��6 W ..,.I,, as owned Q reported agent of owner agree to the..condi_tioonnss,.st4ted on.thiss .. SIGNATURE �. - -- - - -- TITLE + �''.l to- DATE f 'Z - ©,Z 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 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. 3. System repair to be performed in accordance with the above proposal and conditions. Proposal approved S � Inspector's Signature & Title DATE COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML LORETTA MOLINARI Public Health Director •�a:�-'.+.ti r. ..e, -.�^ i_:'` ::.- o.+u`:^e'�v..vas..a�iT•i.�s c .,.a ... -..r.. ._ ,- .� -:.T. ROBERT J. BONDI County Executive 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 April 30, 2004 Hollis 11 Hickory Lane Putnam Valley, NY 10579 Re: Addition - Hollis, 11 Hickory Ln. Increase in Number of Bedrooms (T) Putnman Valley, TM #73.5 -1 -27 Dear Mr. & Mrs. Hollis: 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 April 29, 2004. The addition is approved with the following conditions: of bedrooms must remain at- three - _w_ith6ut -prigr 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 Rush 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. Sincerely, Michael Luke Public Health Sanitarian ML: lm cc: BI (T) Putnam Valley "r BRUCE- R -:- FOLEY ..: .� y „- n �.: -`...� .� =;:^„ �;. yep•= v%iiF�'�: �ubl�c Health �trector 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 x� Public Health Director )r of Patient Services ADDITION APPLICATION (RESIDENTIAL OMM STREET I I L11c kj ��Lf Ltki7t� TOWN Ck� X "g '.0 • / ` Z NAMEANUEvJ -1- �y�611iSPHONE0jS3S -Z - -7117 PCHD# A 115 -0� MAMFINIG ADDRESS ► I-i 1 C. DESCRIPTION OF ADDITION FL/L -L 2nd POO,o /iG�i 1Li0/7 NUMBER OF EXISTING BEDROOMS PROPOSED # OF 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., 4 Geneva Road, Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money order for S 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 eta . -es S1`-2::7 —&i? 3c Feb98 BFhouseguidel ines a r. .�r.ef..�ai.�`.�.a.:.•4 "`i�"^ ^ill `i!'4�^ •:.rf �.1�.= ±...�c.•e .'1...:.%�.., C'..r := :^:rr.o •!,• Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 W ET -A- RN -, Associate Public Health Director Director of Patient Services 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 April 12, 2004 Re: 11 Hickory Lane Residence Tax Map 73.5 -1 -27 Town of 1? -aQn;a-m Valley Gentlemen: According to records maintained by the Town, the above noted dwelling IS xx - Y IS NOT in compliance with Town code and the total number of bedrooms on record is 2 This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: xx OTHER "Building Inspector BFhouseguidelines } NYSRPS ASSESSMENT INQUIRY DATE : 03/16/02 '372800�PUTNAM`^VALLE' �,�0SC �_, M,VALLEY. _+ROL1�`SEC�'TAXABhE'�`=� �RCLS 210 1 FAMILY RES TOTAL RES SITE 1 173.5-1-27 11 HICKORY LANE OWNER & MAILING INFO MISC — HHOLLIS. ANDREW IRS - SS U11 HICKORY LANE 11 �- | UPUTNAM VALLEY . NY 10579 /. | , �". DIMENSIONS BANK TOTAL COM SITE 0 ACCT NO. 111300 SSESSMENT DATA ** CURRENT ** RES PERCENT LAND 29,100 ** TAXABLE ** TOTAL 170,000 COUNTY 170.000 ** PRIOR ** TOWN 170"000 SCHOOL ILAND 34,100 170,gooll !TOTAL 106.600 SALES INFORMATION SALE DATE 06/13/01 SALE PRICE. 165.000 PR OWNER FEY WILLIAM & MARY SPECIAL DISTRICTS TERM VL8 HC OWNICODE UNITS PCT TYPE VALUE 'D"14 Now IP009 / � U | ; TOTAL EXEMPTIONS 0 TOTAL SPECIAL DISTRICTS 3 ===U F1=NEXT PARCEL F3=NEXT EXEMPT/SPEC F4=PREV EXEMPT/SPEC F6=00 TO INVENTORY F9=00 TO XREF F10=RET%RN TO MENU 1�� O9:34:39 SUBJECT RESIDENTIAL SITE INQUIRY DATE: 03/16/02 372800 PUTNAM VALLEY 73.5-1-27 ROLL SEC TAXABLE PARCEL PRPCLS 210 1 FAMILY RES �OLLIS. ANDREW TOTAL RES SITES 1 LAND 29.100 11 HICKORY LANE TOTAL COM SITES O TOTAL 170.000 S ES SITE 01 E S I D E N C E l S/unIco 1 , /E AREAS PROPERTY CLASS 1 FAMILY RES I HEAT TYPE HOT WTR/STM IST STORYh 1224 ZONING RI NO. OF FIREPLACES 1 2ND STORY SEWER PRIVATE 1.5 1/2 STORY WATER PRIVATE NO. OF BEDROOMS 3 3/4 STORY UTILITIES ELECTRIC ATT. GAR. CAPACITY FIN BHSMl } NEIGHBORHOOD 73802 BAS. GAR. CAPACITY 1 TOTAL SFLA 1224 / IMPROVEMENT AND � TYPE SIZE1 SIZE2 QUAN TYPE FRNT DPTH* ACRES SQR Al | 01 GAR.1.0 DET 24 24 1 101 PRIME SITE 175 103 U ====== TOTAL IMPROVEMENT ITEMS 1 TOTAL LAND ITEMS 1 !=MORE ITEMS F6=ASMNT INQUIRY F1O=GO TO MENU F4-NEXT RES SITE ON FILE F9=00 TO XREF RPS0756.'.'. 090026 { LU ate' T : • ODS E.. I t 11 - •. I - I c lL C. �� • � IOW S�� i tc- S ySiL -;�n _ - ` -�`= IZ12 -00 i tcTTg l06- 112 tNCt uStvE `� fiUNt,/�LOt�. i)t_OGIG-. Ai- t6►.lOCO .Ma.A or- P6ft'TtA N OF CAMP LOOICOV? < :k pcAl F-0, . ICJ. Tm-r. .T.o.wu- .O F ru-rwpAA JT' ';!: • �fA11.6Y�y..$Q.EQ -.7.• a�• 31:_:..ad �nQ,R... 1.1a - 12.1 <E. .. .. ;..... -. . . '4 '•� .. .. .. .. A OP s P_� .. rY ♦P�,P `ter W _LI.1?I.'1l -. Sr Cx N :CD_ F wr g 1 1�c. Nd..2� 11 neat,a.►04. ?�f.src�t i'Trf slf,� `bCxW: ! f?vYWA �s ,l<.c£V, .66'•:tiTfi9AR�Vcoi. WN4 G .Ca , QM19a1R�e•Y CuAdLafi`f eo , .; �� ' Qc,YQ 2.G.1 . r� � F: ••a,, "s.:t..?.. 5 :�ti y .:;+ia ,� 2� :ny,�yF -�i +< � �- ' •�i':. i .. — .... •:'L . '� � :ire �'�' � .:: PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES ' PROPOSA iFOR'-SEWA DISPOSAL SYSTiE- tM-RE -P' . �t OFFICIAL USE ONLY 9-311 7-0/ SITE LOCATION'*] � Rick� (�1 -ice_ TM# OWNER'S NAME -A 5 PHONES , y MAILING ADDRESS F � -, -yjAipt 11 PERSON INTERVIEWED PCHD Complaint # Name Relationship (i.e., owner, tenant, etc. DATE i - 1-- ( TYPE FACILITY - £ . l f- rl r� PROPOSED INSTALLER ' iqrA-0 46 &A- PHONE S- Z� ADDRESS ,�P �- �- .�y-�-Ki,I- �l.��t�l,.�.y REGISTRATION# . (3� Proposal (include sketch locating all adjacent wells): !© 9 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. L LC; r, I,. as owner, o, reported agent of owner agree to the conditions ..stated_on this-form., +' ~SIGNATURE TITLE .._._ .� " _.... __... .. DATE 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 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. 3. System repair to be performed in accordance with the above proposal and conditions. Proposalapproved_ Inspector's Signature & Title DATE COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99ML ._- x 5"• n r � �. I ....r.. SYJT-fifm �i•.,`'l:- v�sa�..`!: �._t�, y ^.rn•_ 4,� .P.�:��:yK'...'.� .at >...�./ [�1s �yy�,yA.> _ /000 619-L- �Vqf-- Pt /o0G 6 &L L- ® � e' e T��� A C- - w A �Qe r � � C ' (97, D v <9,Y' e 3l' T/ AJ-6— .1.1 00000" -)loll 541 >, 2 AJ -101cr—\A -P 1 T L4 x 3 26 3'J-" Tx Y'w toll 31 7 6qII �-j q, 3'2 F2E p- P i-cls: C7- c.c O567 0 Z/7 ' V o -Pwor" 2 W C L,O -7',2 1'— -Sq,-r I'LO 3 v'/ 3' CLC)!s C c 0 T I:r,9-0"-r pooh ---------------- 5 4P Tx 3 2- v --7 1 It %A1 tocT lh' J_1 �z �� W � a Gil Q) v � °d W NAM, CON IV DEPARTMENT OF HFAM 14011 SE PLANTS APPROVED FOR BEDP004.1 COUNT ONl. .Y, m "1 7 H � (Ij t N �d cu o o � o 0 &� 4 c, 0 C7 0 W L H � (Ij t Co N �d � Co o PUMA'M COUNTY DEPARTMENT OF REAL T14 HOUSE PLANS APPROv ED FOR coli NT ONLY, 0 --BEDROOMS &.-Title W -a T Vim. 1_41 Q) U) _C� v A.z. U BLe- ODOR - _$ _V_ C11 �d � o o � o PUMA'M COUNTY DEPARTMENT OF REAL T14 HOUSE PLANS APPROv ED FOR coli NT ONLY, 0 --BEDROOMS &.-Title W -a T Vim. 1_41 Q) U) _C� v A.z. U BLe- ODOR - _$ _V_ C11 A r�ra ,i(m ;{�'v � ._ n.r_ww {:n 'oiv+r.o SGr o a.. _� _�.r - „ip�•.. ..► >. -a :.oF.r _.... -.. •�... O >� A � O_ o� cl c r p Z D Uj N► ....,.,.._..._...,_...� .. __ _ _ _ .�_ PUTNAM COUNTY DEPAN ENT OF HEAL HOUSE PLANS APPROVED FOR BEOROOM COUNT ONl Y; �= Jdc CA J� sfi N 00 t 3 z y r t� �1 n A `V ....,.,.._..._...,_...� .. __ _ _ _ .�_ PUTNAM COUNTY DEPAN ENT OF HEAL HOUSE PLANS APPROVED FOR BEOROOM COUNT ONl Y; �= Jdc CA J� sfi N 00 t 3 z y r t� �1 f 4 �w 1 O O Id'j--r or �,_.......� ..- ..�. --- -- .......^....'..""."_....rte. d'_ PU it 4h, COUNV DEPARTMENT OF HEALTH 'QtrSE PLANS APPROVED FOR REDR0041.1 COUNT ONLY, � �3ENR�LS W rc �z I LA t� _ '4 � r V \, V C� �1 0 � I mr.-m O 0 3 0 PMAIVI COUNTY DEPARTMENTOF HEALTH IZ�- HOUSE PLANS APPROVED FOR COUNT ONLY, 0 3 BEDROOMS are & Title Date CA VI) NJ No QL fo L � � /< PMAIVI COUNTY DEPARTMENTOF HEALTH IZ�- HOUSE PLANS APPROVED FOR COUNT ONLY, 0 3 BEDROOMS are & Title Date CA VI) NJ QL fo L � � /< PMAIVI COUNTY DEPARTMENTOF HEALTH IZ�- HOUSE PLANS APPROVED FOR COUNT ONLY, 0 3 BEDROOMS are & Title Date CA VI) O� A O p � � r� a is r 7-N� PUT NAM COUNT`! DEPARTMENT QF HEALM HOUSE PLANS APPROVED FOR BEDP60,fO C. 01I.JIN, T 0NIY; 3� BEDROOMS - - Signabire & Titie t� rn� ; ti Q T C� Lh o o Ll PUT NAM COUNT`! DEPARTMENT QF HEALM HOUSE PLANS APPROVED FOR BEDP60,fO C. 01I.JIN, T 0NIY; 3� BEDROOMS - - Signabire & Titie t� rn� ; ti Q T C�