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HomeMy WebLinkAbout3557DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74. -1 -32 BOX 28 1 17 I 'I'� J if N r Lj r 03557 3 1; j' PUTNAM COUNTY DEPARTMENT OF HEALTH $01934 Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM Putnam Valley Town or Vilffiage Located at Boswell Road Tax Map 62 Block 9 Sutycfiotrclr :•;�BeS.k��G�,� =� �5= ���AS, >�:�'.;1.£.t- 4�o,. _ - �n:•- L-�� -� 1�: .::c -:,:: - - - ,_�::;c'�1!�..�3 :�:.,�s,.,.:. _ T Owner McGlasson Builders, Tnc. Address 93 Gleneida Ave. Building,Type Modular Lot Area 7.550 A. Carmel, NY *10512 Three 600 Gal. 1160 Number of Bedrooms Design Flow Total pHanbitable Space Square Feet Separate Sewerage System to consist of 1000 Gal. Septic Tank and 429 L.F.. x 24" Width Trench To be constructed by 12 Owner Address AS above Water Supply: Other Requirements Public Supply From A Private Supply to be drilled by Add ess 100' x 5' D. x 24" Wide Curtain Drain I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the separate sewage disposal system above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rules and regulations o e u nam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill be 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 place 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- ance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto; 2) that the drilled well described above will be located as shown on the approved plan and that said well will be install in accordance with the dards, rules and regula ons of the Putnam County Department of Health. Date 26 May 1981 Signed P.E. X R.A. Address R.D. 9, Fair S r kJXJ Carme N 10512 License No. 29206 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless construction of the building has been undertaken and is revocable for cause or may be amended or modified when corKITe—rft4iecessary by the Com -oner of Health. Any change or alteration of construction requires a ngw permi Awed for disposal of domesti niter ewage nd/ r p ' e only. Date (rw,e By J Title NJ PERMIT #PV -19 -81 PUTNAM COUNTY DEPARTMENT OF HEALTH "Ilk S01934 Division of Environmental Health Services, Carmel, N. Y. 10512 � F Ci3€TR�T®N LOMPL�14PfLE ror^ EV AO 3ES A ' S`SiEL�: -4EAU GATE -6 Town or Village Located at Boswel-1 Road Owner McGlasson Builders, Inc. Separate Sewerage System built by Owner ,( Consisting of 1000 Gal. Septic Tank and 3 — 8' lu x 10' Other requirements 105' x 12' to 5' Deep Curtain Dr Tax Map 62 Block 9 Tax Map Lot k 15 SUM. a 45 Address 93 Gleneida Ave. , Camel, NY 10512 D. Pits = 801'[1 @*16 -20 Min. Rate ain x 24" Wide Water Supply: Public Supply From X Private Supply Drilled By Boyd Artesian Well Drillers Address R6 ute,_ .,52,. Luke Carmel 4 . 10.5.12 Building Type Modular No. of Bedrooms- Three . ogre Permit Issued 6/4/81 Has Erosion Control Been Completed? Yes I certify that the system(s) as listed serving the above premises were constructed essentially as shown on the plans of the completed work ( copies of which are attached), and in accordance with the standards, rules and regulations, in accordance with the filed plan, and the permit issued by the Putnam County Department Of Health. Date 8 Dec. '81 Certified by l,- v R.D. 9, Fair t , License No. 29206 Address Carmel, NY 10512 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 unitary sewer becomes available and the approval of the private water supply shall become null and void when a public wa pply becomes available. Such approvals are subject to modification or change when, in the judgment of the ¢oriLmisgioner of Health, such voc*05n, modification or change is necessary. Date 1 "^ ^ ©� iJ F By Title .. Y STREE L AT ROUTE 376 JP O.''BOX 10 k HOPEWELL JUNCTION, NEW YORK 12533 K (914)221 2485 s - 'NAME:TM 1VIaiiopac Paii Terrace � � �Fashkxlla 1V,' SAMPL'INGFPO,INT @ BOSewe TREATMENT, CHLORINATED J7( QURCE = DRINK'1NG WATER'❑.V COLLECTED BY::1/IC"rls.5�o1d ❑ APARTMENT COMPLEX ❑ INS' ❑BEACH x �� - 4 ❑ MUI I❑ CAMP d ` ❑ N ❑,FARM LABOR CAMP ❑ PRI' ❑ TOTAL COLIFO94COUNT`M F T ❑ 'FECAL COLIFORM :COUNT;M F T ❑ ;FROZEN- DESSERT` :ELATE COUNT a n - .LABORATORYTECHNICIAN 4 � � k Y s: WPANY a . µ i(IPLE NO. '81.. 26-73 J Tft 13ECiavl�o � a',R�X^'�"�'l.+•Y,Evl�•� a -F •avo �' '';CT "'Li5 ° i$�a ,.. ST a 4 V k*a�le�T _DTHER YAM DATE,.:,,: �. -`18.' IESIDENCE � ❑SWIM -POOL fiz. :❑ TEMPORARY RESIDENCE ` *fir & r r,. a Q•,z $,i. :. •❑ TRAILER PARK AEATMENT PLANT.: D OTHER _ ❑ TiOTAL COLIFORM COUNT M P.N PER 1100 M'.L _. O FECAL COLIFQRM COUNT N PER 100 M :L: , '❑ AGAR`:PLATE =COUNT PER 17 M.L. _ • - x Y 1 S EEID -t .��p PUTNAMf C0UUi sY ' DEPT OF HEALTH EALTHVEPT-4 7 FROM Putnam Co. Bd. of Health LAWRENCE BELLUSCIO, P.E. Div of . Envrnm' tl Health Sv' s 92 Perks Blvd. 4 Geneva Rd. Cold Spring, NY 10516 Brewster, NY 10509 Ph/Fax (914).265_ -9342 *51.For.Fax....._ 1 G.t.. ^��'t �` -- ✓ i iA:�r'+M .: 1n:11 ^._.ti +�. ts�•'f b:'!' .• iaw7 .t.. )..• v,.r- •.�� .rP il`•' lwn :merit .f.�w wn>.' RDe cur • -t w.: 0^ :hS T. �•.I'.•Sl. M.'I - r"Y�a+P'. \i).. w•�.�n �-.L �: Attn: Adam Stiebeling, Re: Expansion of SSDS - Fisher SUBJECT A.P.H.E. T.M.# 74. -1 -32 ti DATE April 16, 199 Dear Mr. Stiebeling: The.inclosed SSDS expansion plan,is submitted inorder to accomo- date the.finishing of the basement areatfor the above residence. A 100% reserved expansion area is shown midway to the rear of the lot. If I can be.of any assitance in the review of this project, please.call on me.. Very truly yours, Lawrence.Belluscio. Incls: (3) -SSDS Plans (2) -Flr Plans (1)- $100.00 Ce.rtf'd Check (1) -LA 97 (1) -CP 97 (1) -Bd Rm Count (1) -DD 97 ,Add. - .Application cc: Karl Fisher, `Applicant ~ - MED... ... _ _ _........._.- .:.... .....� - .. 4 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM PERMIT # 14 Located at 39 Boswell Rd. Town or Village Putnam Valley Subdivision name Boswell Estates5ubd. Lot # 45 Tax Map 74. Block 1 Lot 32 Date Subdivision Approved Renewal Revision Owner /Applicant Name Karl & Lorraine.. Fisher Date of Previous Approval Dec 10, 1981 Mailing Address 39 Boswell Rd. ,g Putnam Valley, NY Zip 10579 Amount of Fee Enclosed $-1 nn.nn Building Type . nn Lot Area 7— No. of Bedrooms _4 Design Flow GPD Ron Fill Section Only Depth Volume PCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Separate Sewerage System to consist of 1 non ra 1 gallon septic tank and (4)-gl d is X. 10' -0 P.C. seepage pits Other Requirements: To be constructed by T. B. D';, Address Water Su I3Lj. Public Supply From Address :or., ...x Private Supply Drilled by - Existincr� Address S rj; I represent that I am wholly and completely responsible for the design and location of the proposed system(s) and�that the separate sewage treatment system described above will be constructed as shown on the approved amendment thereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on'completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be 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 place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or any repairs thereto. x ) YX —Date 4 -16-AA Address 92 Perks Blvd. , Cold Spring, NY 10516 License # 49002 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved f e of domestic-sanitary sewage only. By: a Title: Date: S �J White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Desi gpl rofess' nal Form CP -97 R � . o DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New . York 10509 TeL (914) 278-6130 Fax (914) 278.7921 PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY) BRUCE. R, .FOLEY -... Mlic Heallh-aDirector STREET 37 TOWN P"" Wl/ TX MAP #„ 7 NAME 44-1 ' = ;-1Xe, PHONE s-z " 'YO3 PCHD # MAILING ADDRESS 39 ?--d �M /V-7. I -S 7 9 DESCRIPTION OF ADDITION f ;�'" i u "_'/ NUMBER OF EXISTING BEDROOMS S 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. . _!.. w— r.. .may • - .p --.-� .q .. .. c _..�. �, .. ...... ..__ •'P ,w. -_ ... ...... .._� ..o.. xs�a .— _.... --••O +.R .p .. .r+. — • T ... .... 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 2. Sketches of existing floor plan (drawn to scale, all giving area including basement) * 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 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 Certlficatlo>l�froih B*-Dept with legal bedroom countK`of:dwelhrg OFFICE USE Comments Feb 98 1 DEPARTMENT, OF HEALTH Division , Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: BRUCE R. FOLEY, R.S. Acting Public-:Health Director Re: Residence Tax Map '7� �- Town M �. According to records maintained by the Town; the above noted dwelling IS NOT I in compliance with Town code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER '�t )t6 40" 5p, ee o� CL Building Inspector 4 .� FUTNAM COUNTY DEPARTMENT OF HEALTH _ .. D HSION OF ENVIRO �T1Q!TF,�T'�'AL H_ E AILTH ERV , ES.. - LETTER OF AUTHORIZATION RE: Property of , r-1 q.,v4l 4r/­h^Ae s d1j,r- Located at 3 ! �s w�- >i �o4-J /�� 1/4; y °s7 y T/V Tax Map # 7/° / — 3 Z Block Lot Subdivision of Subdivision Lot # Filed Map # Date Filed b Gentlemen: This letter is to authorize Lawrence Belluscio a duly licensed Professional Engineer �_ e ' to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on Wbehalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems i s rrii v with the t�z �r�s ns Cf Article 14�- nc;�n� °..1 :7: of the_ E 1. catii ©n.;✓a��r. t1:ie, Fu'c;iic Health _ w _..n. con.. _ Law, and the Putnam County Sanitary Code. Very truly yours, y Countersigs��36'�� igned: r P.E., ., # 49002 (Owner of Property) Mailing Address 92 Perks Blvd State NY Cold Spring Zip Telephone: 914/265-9342 10516 Mailing Address: ' 3 P & r ?� State /Ve--i L,.'x Zip / Q 5--�P9 Telephone: Form LA -97 PERMIT #PV -19 -E McG1;ason Builders, `inc. Putnam Valley. - 0wn6 r`or Purc a.s.er o Building Municipality Owner Tax Map 62 Building Constructed by Section Boswell Road 9 Location - Street Block Modular 15 Building Type Lot Boswell Estates Subd., Lot #45 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 o negligent a.c.t._o'f. :- the-- oc.c-upant of:;the huildin utilizir the:. s. . Dated this 8th day of December 19 81 Signa re Title I c oration, giv and address) 01ca .. I'- THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMP,ETION 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 DEC 101981 PUTNAM COUNTY DEPT. OF HEALTH PUTNAM COUNTY DEPARTMFN T OF HEALTH Date 29 October 1980 Res Property of McGlasson Builders, Inc. Located at Boswell Road, T. Putnam Valley Section 62 Plat II Block 9 Lot 15 Boswell.Estates Subd.,. Sec. "B",,-Lot #45 Gentlemen: This letter is to authorize Johh 14• Prentiss, P,F, ; a duly licensed professional engineer X or registered architect (Indicate) to apply for a Construction Permit for.a separate sewerage system; .to serve the above noted property in accordance with the standards, rules or regulations as promulgated by the Commissioner of the Putnam County Department of Health, and to sign all necessary papers on my. behalf in connection with this matter and to. supervise. the constructi -on; of ,staid= system or systems in with the provisions of Article 145 or 147, Education - h iii lth Law, and the Putnam County Sani- 7f t tary Code. PUTitiMN; .,_ jNTYi DEPTk DE G 'd- e ' tersigne P . E . , R . A . 9 # 29206 oFESSi .a, 9, Fair St. P Address Carmel.,.NY 10512 914 -878-6170 e ephone Very truly F x',�y Signed No" '292 THE sSAj�� Owner of Property 93 Gleneida Ave. Carmel, 10512 Address 914- 225 -7964 Telephone THE OFFICERS SHOWN ON THE CORPORATE AFFIDAVIT ON FILE'WITH THE PUTNAM COUNTY HEALTH DEPARTMENT.HAVE NOT BEEN CHANGED SING SUCH FILING. ....r,•.-.. .:, �.� ti.. .. ..' y_.. :.. .,. .. _ pig z�+ �� _ 39 BOS EpLR®pD PUT NAM VALLEY, NEW YORK LL ®57 9 (845) 528-9403 Putnam County Department of Health May 1, 2001 Carmel, New York, 10512 Attn: Mr. Bill Hedges BY HAND Dear Mr. Hedges; Let me first apologize for the delay in delivering this request. I was not comfortable with the alternative of leaving it taped to your office's back door. Enclosed please find a copy of the "as built" diagram as prepared by F.W. Rush, III General Construction, Inc. This diagram reflects the expansion done on our septic system. Also enclosed is a copy of the original plan as prepared by Mr. Lawrence Belluscio, Engineer. Mr. Belluscio inspected the work during excavation, and was satisfied with the work performed. As such, please approve the "as built" diagram so that we may move forward with _ ..., .r. _ .. itia ±e& h�.o.: secunga ccfi fSf- y o LeTnf.-Putnam Valley. -; For your convenience enclosed is an addressed, postage paid Express -Mail envelope in which you can return your approval. Thank you for your attention to this matter. Sincerely, Karl and Lorraine Fisher 2 enclosures • . •.Fr;;�.a. Sgt; • due •v =V M tr• _ ��.x . r.: ac, : -. e`,�, j�- '�..,,_,�0.0.� 1 111(• l.� �Y rF�..•_ �� ��_.•l't le''+ 1`tv YNY� .+a`�tl iC: -.._� — .- , /y�:•�•... --i .`.'•�. _- _ t�l .' ._. _ -- _ ... ..., .. . aY � • IF y� � t .j yam. _.. _ / ._._ —^�.. ,�" +'-:,...'.� --.,., .. . ''►' r .T. I f 7, . � � s .J i ,M�7� .. ; - ..�— _ .- .. �� � .s . pT :iY- '"'_.._ • _.'_- __'Tr` "a.�+..�."_ i_,,, '!= Chi �a L':.�., �J 913'T• ioA' P--.:1 am County Depart =;,lr:; ll- ,;Dion of: nvironmp ,l`.P? !''. '!;",.•'ed as noted for witn�- ':lca►�le Mules and F sgulMiol'is mam sin ealth Depairtment. - __ � >�� � � —� ..- •^'�t.�+` ";ors •.ayT �.�..•�,. !%Signature & Date �.. N..L c+, r � / , ei 'xs f? L'. 'i # i :-J, !3 "�'`i S: " r's•,. d'm`r is ;e`er i� �`.1 i?' �Sa... _ �. id,� $1 n ; \q `% �°� .GOD l>im6.1- .v f�'i ,?br�,w�_�t. .e'•;a4�.�^r.,, - -,_u .,_ ...t _. _.__,......._ .•SGT:.. , f�n;'!� `- �:�A +•J[ i .. _.. ..._. .. .._........w.....� '.,_ _ iet: B.9 .�SCr� ... ..''� ;:II.: ° g� ����Ce^% �T i .•{c �. 'A L:A�•'°'� ..�.:�vdf� ... .....•.. -.-... .._ .... • I � :`.,17•r ':T'•C' .`•r= •':::i7iQ nl:i Ea 3:. 1 ?.1� -,; 1' •1 �Ci`2! "j !i- C .,''e,'�7+1 "�3 I+[. V. - ,•S.. %�• _._ �'so�.t__ ..v_'r: .�:3Ls• I: ',+'�}= .iyv:.�' i ... �.. � ya Y1..ra :. _ _.________. ..._ , ,_ . — —=-.t i ; , w n `e i. c _ .4• : .:d x S7,. Was S'-' • `�.. . ,_ i�'t'k '_ , \1. "•� .; v i ' , � . �T .+w � :.. � iq N 7 4� Y s ; � ' . r..r .- W ••f' y .�1 �i. s � 1, r ++`✓i7�., .• .c,. +ate . + �r ",�c.'S' - '.M: \r -�y :.rfi. •w.: '_ "t ♦ -..v .�aya4 .ta•+aM'O, _-� .. �'� .. '+. -Y:,f - y:.wrn •:..w... it ilh::.:�_. /v f fi: �,� - 4 -. =,�:h ^ - ...... ''�a � tea.: �w,y •�.� T, Ste' ivy,,.,,, �' >i_j _ ` °a ,�',; ya•. —� — !:; �r,"�" ,�.,� •s ____ ^ ''+' __ _ �. _ _ _ • ... �y 1 - .r•.•. 7a�r _ :'?i'.'. .�s isu. ,.� '::e.:ni:� 4' �, '�.: .�• 7iw9y '!fir ' - tea" „",... ••"rY l t . i..•:,:IOn OT:; ; e as noted for with _ -- licable Rules and Fie ris of t►ie� ` --__ ; :; _. ,.. _ _. ........ , _ . Znam �lealth Department. t ; Signature 8� Tole i�at® ---- -- - >r � .fie ,` M YA M ••,i. —F ::jbi? �. Al 1T b: '� �•.a w'..�.. tl� -'� �AiY �'�_:}�u°, .•.^Y f'SO:..._ �Y'9/r • _. =_:;t .; - - _ .S::t::, :1' :[itia key �lF i 'a �E,i>�. St(•.Y�i tiab ,'r^01, L i!(v: >'^{"St"'Y - `,;'.t'ti:s'f.;. �.. -- tt_ U.a .•�:?.:� ..... .n� -', .'wJ.:_P B t IS j i i .' �:. s°w i'�: .�t .Cad f'% •'rat' •�-. • ..- ...-.� 3 ter: Ea' •J•c 1 ? ?q'il 1 y! r J�3 �C�/ I^ . �,y11 .''• � Jta: r'r.' • id,'�':e �Fi _ — .,. -- ..- .- ... -,._ , � �_ � _• - ,-.i �k Y. t:ti L. r. iM C' wi„c ate. �3 �1 q+ i `e-i• ��.. .. _ ,, �V ,:wy • —� rr • i1 .'t.��i • ^; ":. ie; b ay 7 t`•."r• � n . r .- ._ : i .. s .. LORETTA MOLINARI Public Health Director 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 May 21, 2004 Fisher 39 Boswell Road Putnam Valley, NY 10579 Re: Addition - Fisher, Boswell Rd. No Increases in Number of Bedrooms (T) Putnam Valley, TM 474. -1 -32 Dear Mr. & Mrs. Fisher: ROBERT J. BONDI County Executive 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 May 20, 2004. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at four without prior 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 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. Sincerely, Michael Luke Public Health Sanitarian ML: Im cc: BI (T) Putnam Valley ' .A _ ....: BRUCE -R: ;. OLE" .. .. _�.._... ...w - Public Health Director f f /dY 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 Environmental Health (845)278-6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6618 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLY)• STREET 3q 6 &5�wx i t R p ej TOw0A- d,, V', 0 TX "9 -7,4.-)-3Q NAvIE KoLr I -f �&ra;ne Fill PHONE Fy5 5 ,28 -gya3 PCHD# A I q 6 -0( r MAILING ADDRESS 3q bos w e l l �a j VL 1 f 4 L/ 10-5 -7 DESCRIPTION OF ADDITION Rd l ir) ', Netj n j1Jen * �eln nh -! nm �bw -A /o0 yn NUNMER OF EXISTING BEDROOMS_!j_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 o6r er for $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 BFhouseg idelines 0 E+� DEPARTMENT OF HEALTH Division ; Of Environmental . Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Residence Tax Map '7� Town Gentlemen: BRUCE R. FOLEY. R.S. Acting Public-.Health Director According to records maintained by the Town; the above noted dwelling IS IS NOT b in compliance with To\N-n code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER 11/ /;VV4r­�I&� J3 c4-1 /1' G� Building inspect i " 7 51 PUTNAM COUNTY DEPARTMENT OF .IALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY; K BEDROOMS S9p t @� fUfU Title +r iS. FISHER RESIDENCE ADDITION WELL ROAD, PUTNAM VALLEY, NY 10000 A -1 ,. =ra 4 10 awn AW." CORRAW MOM W. 10567 - i' k, F,. �I y /`lam NEW DECK , I if" if IMF% III 1.1 j* zr4 ---- — — — — — — — — — NEW KiTCWN' PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY; BEDROOMS Signature-& -Date cm YAP. zom MRAMRS. RSHER RESIDENCE ADDITION 39 BOSWELL ROAD, PUTNAM VALLEY, W 10000 ADD= RAN A-1 ZmvA m sm ALL 10 aaalA AV" cmum wwk Ia. 10561 PUTNAM COUNTY DEPARTMENT OF HEALTH --- - -DI VISION OF ENVIRONMENTAL HEALTH SERVICES a�w �L' � _. .. ... •tom • .. < �+ - -' CONSTRUCTION PERMIT FOR SEWAGE TREATMENT SYSTEM IPERr�UT # Located at 39 Boswell Rd, Town or Village Putnam Valley Subdivision name Boswell EstatesSubd. Lot # 45 Tax Map 74, Block 1 Lot 32 Date Subdivision Approved Renewal Revision Owner /Applicant Name Karl & Lorraine-Fisher Date of Previous Approval DEC 10, 1981 Mailing Address 39 Boswell Rd, , Putnam Va11ey, NY Zip 10579 Amount of Fee Enclosed $ no. nn Building Type .q _ F _ nD Lot Area —7+� No. of Bedrooms . Design Flow GPD R n nn n IFill Section Only Depth Volume IPCHD NOTIFICATION IS REQUIRED WHEN FILL IS COMPLETED Segaarate Sewers eg_System to consist of 1 n n n-ra j gallon septic tank and (Q-81 d i;a X 10' -0 P,C, seepage pits Other Requirements: To be constructed by T B. M� Address Water Su ® ®la: , Public-Supply From . Address ®�: X Private Supply Drilled by T?xi t; „g Address 4. I represent that I am wholly and completely responsible for the design and location of the proposed system(s) andihat the �epazate sewge treatment s sy tem described above will be constructed as shown on the approved amendment th ereto and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and that on'completion thereof a "Certificate of Construction Compliance" satisfactory to the Public Health Director will be 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 place in good operating condition any part of said sewage treatment system during the period of two (2) years immediately following the date of the issuance of the approval of the Certificate of Construction Compliance of the original system or. any repairs thereto. Si .E. x Aix Date 4 -16 —gg Address 92 Perks Blvd, , Cold Spring, NY 10516 License # 49002 APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the sewage treatment system has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Approved lea a of d ic,sanitary sewage only. By: Title: Date: White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Desi rofess' nal Form CP -97 CERTIFICATE OF COMPLIANCEHOCCUPANCY CERTIFICATE NO.: 2001 -142 PERMIT NO.: 1999 -730 TM#: 74. -1 -32 DATE: July 27, 2001 LOCATION: 39 BOSWELL ROAD ISSUED TO: FISHER KARL & LORRAINE This certificate covers the construction of: FINISHED BASEMENT (1,047 sq. ft.) The applicant having heretofore filed an application for a building permit pursuant to the Town Code, Sanitary Code, the Uniform Building & Fire Code and the Laws in effect in the Town of Putnam Valley, Putnam County, NY, having paid the required fee therefor and the undersigned having by personal inspection ascertained that the applicant has subsequently proceeded with the erection or improvement of the proposed structure in compliance with the requirements of the laws as aforementioned; that the said work and materials met every requirement of the laws as aforementioned; and that the premises have now been fully completed and are ready for occupancy pursuant to the provisions-of law. Now, therefore, this certificate of compliance /occupancy is hereby issued under the seal of the Town of Putnam Valley. TOWN OF PUTNAM VALLEY, N. Y. By: CODE ENFORCEMENT OFFICER 0 M PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES = DESIGN:.D —A SHEET.-- SUBSURE E SEWAG TREATMENT SYSTEM ,:... Owner " ri Address Located at (Street &.e kskiL! G o�d� � Tax Map 7M+ Block I Lol Z • (indiate nearest cross street) Municipality e l) I u7�ya.�yd Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre- soaking Date of Percolation Test: IVUTk;b: . 1. :'Tests to be repeated at same depth until approximately egiidl percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31'-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole: :. Fonn DD -97 Depth to Water Water " From Ground Level Percolation Hole No. Run No. Time Start Stop Ela se Time �1Viin.) Surface (inches).. Start Stop Drop In Inches Rate Min/Inch - 1 2 4 I l 5 � 1 ' 3 .. 5 .2 .3 4: - 1 IVUTk;b: . 1. :'Tests to be repeated at same depth until approximately egiidl percolation rates are obtained at each percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31'-60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole: :. Fonn DD -97 Design Professional Name: Lawrence Belluscio Address: 118 -8 Perks Blvd o - " Cold Spring, .NY ....105.16 Signature. ][Design Professional's Seal 05 G� J BFI y� 3 O �.i. 0 (P c PED {O� 6 OF N.-. i AV PUTPIAM COUN'T'Y DE'PARTME",qT-_OF. 11PA'Lli'll - - 'VTP S DIVTSION OF EN ZONIM02-1-TAL HEALTH SERVICE COIJDI'IY*OFPICE BUILDING, dAJVVFj,, N'. y 10512. DESIGN DATA SKEET- SEPARATE 30 ,,'AGE -DISPOSAL SYSTEM FILE, TIO. Owner M-cGlasson-Builders, Inc. Address Boswell Rd. Located at (Street Sec. 62 Block 9 Lot 15' 6dicaEe. nearer t cross street) Subd. of 45. 14unicipality Putnam Valley Watershed 'D TO BE SUBMINT'r, D WITH APPLICATIOT-3- SOIL PERCOLATION TEST DATA REQUIRE hole Vurriber. CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to.1-Fater •,,ater •eVel No. Time From Ground Surface in Inch6s Soil Rate Start-Stop Min Start Stop Drop in Min../in drop Inches Inches , Inches 2 Owe 617 3 114,4 la 7&_ 4- 4 2 .PUTNAM.' COON Ty DEETd OF HEALTH Notes: 1) Tests to be ro.pe� 'ited at same .depth until a� imately cqual soil .yroy, . .rates avo obtainod ,.It each percolation test hoie. A data to bb Islibmitted for rowi,ew. 2) D_%ptli wcacurementc. to be tinde from I-,o*p of hole. TEST PIT DATA ]IRM)IRED To BE Sin DESCR"I'll'TON Of 30]'I;j* j'iT.'C01JN'VNPF'D 114 .DEPTH HOT-B... 110? 110LE, NO. -G-L. 1211 1811 2411 A y J 30" --'72f .8411 INDICATE. I.DrEL AT CH GROUND WATER 'IS ENCOUNTERED 1V9 �p_ JNDICATE IEVEL TO WATER LEVEL RISES AFTER- BEING ENCOUNTERS' W. TESTS 1,10E BY 12 Date 7/S)O W If Soil, Rate Used -A-)o MiiV1%)ro,p: S.D.,Usabl.e Area Provided" .No. of Bedrooms -M-ee_* Septic Tank Capacity Gals. Type iLf4sati /.C-M .Absorj?tio n Area. Provided By�L-F.x24 Jb1r iqldth trench. WOS er E I N41 /J., /- .__ . Oth/_ _ � _ _4_ - . Name Address Wt THIS SPACE FORI USE BY BEAU.PH DEPARTMIENT 'Soil. Rate .Approved' n/Gal- a Date I y 4 . f: } i s s EXIST EJCI57 KITCHEN > ` r BftTHiZOOM EX15T. :BEDROOM i � y}E d t j M ' DININ6RGc?M a Inv fi -: _ � a > 7. t t y �T ,''�- t y , k r ',, 7 a e �`•� r� � t � ' % s �, � G�T a a " � 1 �, i 4 s ar.. - ti.._ t1 �•*�t• -. 4 4 b N HEAC)RCOM IS Yu .� ;; 4 d i,t'I{NI�TAlNED A TAIR 601N6 r t; �.'t ; • 1 , t �r DOWN T[J6. ` t .a SLIT BEDROOM cis r z a t •� � EXisT BEDROOM � � o a �, � f � ; too Yt L r s~ v NNW 10 EXIST UVINGKRQ i I •"' LiNE CF 5t1ELF O r T - r s kLONc t— UP 6R ItAN RPJL f Z EX19T WINDOW � F,2- 'EADHi '"r^ jh - ; �CI9J AfNDCW � j tix �. . `'ate_ � .- .t;J. -t � �,•P yi".3. ( � ` - .?S. "� AS .e. S 4XgFIG P05T'1 '� . - � F�REhI[7VRD GLGSE � 4' x r s 4-` ; rte' " t `- ,EGURETY TQ.GONG - 2-])0� i'G�D62 08C/AE i UP OPB:IINS - +: P05T.1 -.F s - r NF1'1 EffRP.NC,E. DCG¢ >F IT'S -i 1 .cy`r y t y,, • � -�� �' '�'�a. ,r •zi'f `+'(rt' ` '� BASS k: I � Y!/ (21,i.-0 WIDE•51Df3itr5 :- 4 I �; N ; :.r t� 1 �, . j f� 1 a �• � s " "..� .r �, -x � c • MOYD�EL .TO BF- SELEGIE-D �'Ui•fNF1{ - ,. f? g-0 C.OfJGREiE'S7AIR I f X .w t '• , _. a zit Ijx� _:: � Y ..�, fit.., r4 �_ -• �.. Y i �.- r r �'" s < L. _` � Dr mss.}. s S..- � 'ti t ExtSt•IN6 WOOD C�GK k�4 , t a� FtRST,SFLOORrF'LYI�N T�tRErrovW - ;.._?E ., � - 5: Y D f 3 i. u _yY - f t .t e. 4 s t �7 � BASMt?iT F FOPS ®'�''�� t l t: - • . It'.. � CD o It C3 _ w b �3 a �� g6 y � 8 � ggadd yak � gtl yyQQ 6 R � �cy, {Eo�j ° }x }x ce rx r------------ - - - - -- - -- ------- r ---------- - - - - -- -- . It'.. sJ t r .;o 3 o irlgy, o 7Y — /— 31 i. FlSHER RESIDENCE ADDITION VELL ROAD, PUMAM VALLEY, NY 10000 —• PLM A -1 •ZMW M SMq Au 10 OWED AVM •mRMM wim M. im , y�t /ar i q pt 9 II . 13 ti 410-• It4PL,&,VL CV4-,r W/vr- . 0. a. x, fh A, A. rF. 0, 80,e so__, 400 420 3 SO ^%a OJU JAOIO OF C-Pso P¢O Pea EP G'Owo- v rr. 0 V--j ICAP61 O.C. see PA40 P,T-- 37 0 I j I� ..."1 &0 Cr SOS r 4 04 7"'4d-r*S 0, od PLOT PL AtO Putnam County Department of H Jol vision of Environmental Health :: ervi 'r Approved as noted for cOnformanc) wl applicable Rules and Regulations Yut of Qti +q oA-ry Departmc =17.— =7� IYY4 Signature Title &To LAwFtQ"C6 8ELLQSC10 P.C. 49002 PGKI�."S Sk—VO 9342 'n wsc S. 40 1 94 1 ..._ , 1 � L J _- J 7p- OVniTii lMV @'Q V4L•' PD14 OR= Y'f ae".oce -Hi wTtD1 = w . NOTES i 1. pipe joints to bb s led ` wtaT '! vith asphaltic mat-1 of FROM SEPTIC TANK "1 ID•• RAIN I 1 equivalent. J _ 2. Invert elv's o; all outlets: x'• • - ::�" : :� must be equal. • .'_ 3. The slope of outlet t veer the,:Aistrb. pipes bm. t - -fix'. 4ti? 1N.s�.un _ ' -' e¢ g2n�tL : - . .be . ,. • °and the d:.'stributor ater +' mils should be 1/8• jar ft. .7Y P PC: DtSTRE 6X WIZAFFLE i'; REMOVABLE :.: COVER 4" MIN..: ' JOINTSWATERTIGHT d: �: VMS' .t .'t. v:t.g ` ' INLET PIPE r' FROM SEPTIC TANK ID•• RAIN I 1 J _ Br MIN. RING OF ' T - WASHED GRAVEL;.':.% •' t" OR CRUSHEDSTONE p ;. 314" to I%'* •' ' 1T MIN.` i'; REMOVABLE :.: COVER 4" MIN..: ' JOINTSWATERTIGHT d: �: VMS' .t .'t. ABOVEINLETPIPE' ' ' I 20" ` bMIN. :e 8•' LAYER OF MAW f OR PEA GRAVEI. _ ' Af', a C= P= Q c= ®� ZSL W ' L ` IS"u8•: OPENING. �: •'7 eA f TYPICAL. ��- ra toadn8t 1� ... 6 ^ MIN : COARSE GRAVEL . /- P C' SEr pA� v:t.g i AS ki U l t t ,z tJ 1.! A 3 1 S'frucfura tncatea from survey by surveyui nn }edy ,below wbit tosorc",f py urveynrs s+.rvey'-�_- wtl Arlii4t9 tenor: --- fr7b f 4 �LSGr'0men - ' 41 lO fA � . l�f:N1 DO A0S�plio,.gOlferle4 F. luter:ais it)•ti)iGa l3y;TOnt1'OC,t r+ I p <I.14eY A/38mY71 ¢o" "k! knulneei: `�. He a fib da,Pt . 7 P(eid Inepectlon =by: tieutrh dept [ t ddd e'- -.28-1 -- �h�e�IJ t! ErigI nee r, ti V t.. NOTES-A) 1 ijr�_r �'[p X10'J, i {5 = 8[ ! ' G [6`)n Qif 70r , 3:; b� IOf' C.rhniti Arai. 12'1D- yNW^Parkln, 70 jtMlrl• T 36k % / 1 j �`�1 DIMEN_51Un [r Pit A zs'- . "8 l �� ,q 4y�z F- ,i � � PU'�£ore1 .+G-�Zj/ li�ow?4/Eac � ��' ;i• 0 E 2" G ri F 77 if A D w�Hb: teQ✓ Ha�£in %s. ! Q A H Co.r c.cfc S.�f < ,y„ .,�, r�:: ¢. • -� s /. / l:V s s j" i , lY - - -p�! !.. \' LO -e ?61T4� .IVwcE F _ SA ?�JlTF•�R`r' -SY 7TEM...DE -3iGN '+.A .`.> B1lit s . IA.N 4w 1 _ n C AT.10 N !P TOrtn: �J . u�c�,1e� '- -Count'.' -- ?cCIBU14iSION:� E TvsKY S 1 'IS- G' Lei `I Map t `1 L uT N' 15 ' • .. - �°yt ,. u Block - _.- ..._ — __ _.- `- - - r 1 - -- • p r r. _ - Builder: . �S r9� 'tP Su veyo Putnam County Department of Health ` .ECEIVE® _ r.> - a .rL �Xn .__ . .. pate: i g Scale: 1 ��. JoG Pd' �.0 \q 1. Division of Envi. cnmental Health Services r k. r Y �_ s �� / lr DEC 10 1981 APProved as rote'd for co_formanae with ti. x - _ - - Dw IaPIIT4cablo T and �,sp J C, H iy H,_ P k t tR! T I S 5 r- Rec;tlations of khe a •i S � l f