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HomeMy WebLinkAbout3558DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74. -1 -33 BOX 28 03558 po 1 2 1. ' kc ? 1 , 61; 1 03558 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, ' N. Y. 10512 CONSTRUCTION PERMITjFOR SEWAGE DISPOSAL SYSTEM Putna aii y i s own or ri- ge ' ' -y TeJc nth . -62 - - �s•� _.,510 f kr,,���- 91ocar d4t" Subdivision _ Bswell Estates Lot #46s Sec. "6 " 14Lot ' Job %►7sAY�7l7FA 501935 Owner . Address McGlasson Builders,Inc. 93 Gleneida Ave. Building Type Modular Lot Area 15.797 A. Camel, NY 10512 h — i Three 600 Gal. 1 ' Number of Bedrooms Design Flow Total Habitable Space - 16D Square Feet.''., .� Separate Sewerage System to consist of 1000 Gal. Septic Tank and 429 L.F. x 24" Width Trench y To be constructed by ? Address Water Supply: Public Supply From X Private Supply to be drilled by ? Address Other Requirements Curtain Drain – 48" Deep x 1101 ti . r'J I represent that 1 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 of e Putnam County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactory to the Commissioner of Healthwill .•. f 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 lssu• :'. ,.i 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 t will be located as shown on the approved plan and that said well will be installed, in accordance with the standards, rules and regulans of the Putnam County Department of Health. t + Date 11 Sept. 81 _. % X i Address R.D. 9, Fair St. ,_tac�me1, NY 10512 APPROVED FOR CONSTRUCTION: This approval expires one year from the date issued unless co revocable for cause or may be amended or modified when considere sar by the Commissioner requires a new permit. Approved fDr di oral of domestic i ary an water Date ®~ By v License No, 29206 i of the building has been undertaken and is h. Any change or alteration of construction Title 1 Permit I PY40 -81. .�: - -- v t _:'. _.. PLI.'�N_�►.M. >O'N'�Y DEPAR'g'1lYL_NT OF_HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 �STIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM - IJ�1jJ,>? jA�� &Y, Town or Village / ?'Boswell Road 62(P1 at II) 9 /Located at Section Block � owner f.ormerly/Mc61 asson But l d,.ot 1.4 Job S .O. 1935 Gl eneida Ave•., Camel, NYC Separate Sewerage System built by .r yAddQress(�pp� Consisting of 1 00o Gal, Septic Tank -four — 8' Dia . Ang Fva Pits width trench Other requirements 12" Stone Surmund 9 'under Faah Pi t Water Supply: Public Supply From Private Supply Drilled By Boyd Artesian a s, nc. Address Rte. 52-9 KeIltf NY 10512 Building Type Modul ar Frame No, of .Bedrooms ?hree _ Date Permit Issued_MP_391 required re Has Erosion Control Been Completed? as .q 1 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, plans filed, and the permit iss by the Putnam County Department of Health.,;' Date 30 August 1.983 Certified by P.E..X —R.A.' ' Address RD 9 — F air S License No.�A206 Any person occupying premises served by the above systems) 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 n I and void when a public afar supply becomes available. Such approvals are subject to modification or change when, in the judgment of the om is loner of Health, suc evocation, modification or change is necessary, �� Title Vt .,,�& AT A 9U O EN of ' T�E HQPEWELL JUNCTION � 2ii NA M E. TREATMENT. t CHLbRM A ft61 SOUROE' DRINKING WA T ER -COLLECTED BY -9. RTMENT-.0 PA PMPL A E X ❑ BEACH, O' CAMP ❑ O,FARWLABIDWCAMP �60TAL`dOLwbRM COUNT j Q, FECAL .666F "'..c6uN'T'. "6 d,. FROZEN 'b6SERT PLATE COUNT ES ONMENTAL NEW YORK -ruvAc T, RESi 1 Z7 hVAtE COMPANY P �Js EWA IlL K MUHA I DA;E H F- I UHT ! 41_;tjffl� . ;IckN , I TW S " WAIT', J, MOMA J"#Y I h. ;-4 V� 7, �Z e s ? ER:❑ NTPLAN't `TRAILER. PART 'OTHER LAB( Aj b INFIRIMMETSMI-11" ml F, 15L '71 MV �00 4 ir " PER Ab'd Mm ORY, D,IRECTOR_ 'ut ev p­ V/1 E Mul I . n PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OFFICIAL USE ONLY C) �v�ygr�l SITE LOCATION I�oS w � V!4-L� -�X TM# 74/.—/-33 OWNER'S NAME . Jtll ,,_, jQ AVf_ S/ &I o Al PHONE 1a'YS S 2 8 779' MAILING ADDRESS 37 80S c�e;l L X& f0u7�yAoj yA t Lkt )vk / ©S 7 JI PERSON INTERVIEWED PCHD. Complaint # ame & Relationship i.e., owner, tenant, etc. DATE TYPE FACILITY G/ �PROPOSED INSTALLER C ALKu G A EXG 4y lRyJ n � PHONE 2 v 7 g ADDRESS /O %5 M A fig 04C �ALZf REGISTRATION# ... Tmono ketch locatin ail A bacMt well ) f 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. `6 �-b �%,a .o -`., s�'l,'���:Gd,Y_ K.0 . ..q I, as owner, or reported agent of e a ee to the' conditions stated.-. on this form. SIGNATURE TITLE S� ©"7 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. Proposal approved_ Inspector %- Signature & - T itie - _ 711, o d� COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99IVfI., I , = X14 I a � � PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES �j6 OFFICIAL USE ONLY 3 SITE LOCATION 3 7 Bof glge, �2ci TM# c OWNER'S NAME A-00 a _ OL01 .S; k4v Y PHONE MAILING ADDRESS j0v rl jn f.IA -41 C� .s may: PERSON INTERVIEWED PCHD Complaint # Name & Relationship i.e., owner, tenant, etc. DATE l d TYPE FACILITY -S� PROPOSED INSTALLER PHONE a2d ADDRESS .0 & 0�C / GISTRATION# 14G I j� Proposal (include sketch locating all adjacent wells): Repair must be ih same Joeaiion and of saine• type as original sewage disposal system .Differefif location may require submittal of proposal from licensed professional engineer or registered architect. 6 „„ _Ctc tmc a-t I, as owneAoreported agent of owner agree to the conditions stated on this form. SIGNATURE 4 V A,5r TITLE :47 DATE OO 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 corners). 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 approve C� .Inspector's Signature .& COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99NE 4 t= 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 November 3, 2003 Dave & Julie Simon 37 Boswell Rd. Putnam Valley, NY 10579 Re: Addition- Simon, 37 Boswell Rd. (T)Putnam Valley, TM #74 -1 -33 Dear Mr. & Mrs. Simon: 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 October 31, 2003 The addition is approved with the following conditions: 1. The total number of bedrooms must remain at three 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. Very trul ours, William Hedges WH:lm Senior Public Health Sanitarian cc:BI BRUCE R. FOLEY 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 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 ADDITION APPLICATION (RESIDENTIAL ONLY STREET TOWN TX MAP# - NAB ` PHONE.( � -- ,�9 72-! gPCHD# A3 71-03 MAILING ADDRESS 3 7 &V I (m `DLSCRIPTION OF ADDITION NLiVIBER OF EXISTING BEDROOMS 'L 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 $100.00. f 2. Sketches of existing floor plan (drawn to scale, all living area including basement) (j *Non- professional sketches are acceptable. l 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 A-' 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 0 Feb98 BFhouseguidelines .. "..e. BRUCE R. FOLEY Public Health Director LOREITA MOLINARI R-N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH I 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 Re: Residence 'fax ma­ P Town Gentlemen: According to records maintained by the Town, the above noted dwelling 0 IS -zl- 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: OTHER BFhouseguidelines I Q-i 4ed 901'M e Eli r-F7 i r�v,"s) 6- --- — ------------- 7 PUTNAM COMM DEPARTMENT OF i AS 'bussE PLANS APPROVED FOR COURT ONLY; _-,.BEDROOMS 0 &Title .rZ�z O q0g 60' j4A4-Vk'1AW' PERMIT # TOWN OF PUTNAM V,ALBEX BUILDING PERMIT APPLICATION OWNER MAILING ADDRESS 31,,9 us w, 141 oArY I;omv PHONE # 'Cr- S'A Y LOCATION OF PROPERTY12 .1%S i, r? t' ir �EST INTERSECTION SUBDIVISION LOT# / ZONING SIZE OF LOT (SQ.FT.) HEIGHT . DESCRIPTION OF CONSTRUCTION DECK NO. OF FAMILIES PER BLDG EST. COST OF BLDG, T D GNSTLTICN "E L^ATiLi�r?£Pi IN ?`IuS F NO _...._ I, , do hereby agree that the Building 'Code'will be complied with whether the same is specified or not; as well as the Sanitary Code, Plumbing Code and any other . Law, rule or regulation affecting said structure of building. The Inspector shall have the right to enter any premises during the daytime, at reasonable hours, in the course of his duty. DATE: (Owner or Agent) PUTNAM COUNTY CONTRACTOR'S NAME & LICENSE # I find plot plan to conform to the Zoning Ordinances of the Town of Putnam Valley and hereby approve same; subject to further approval and compliance with the requirements of the State Building Code and the Sanitary Code of this Town, Plumbing Code, as well as, any other law, rule or regulations of the State, County; Town or Bureau or Department hereof DATE: BUILDING AND ZONING INSPECTOR PAID : Building Permit $ Sanitary Permit $ ZBA APPROVAL Plumbing Permit $ RBL APPROVAL Well Permit $ P.C.B.O.H.. $ PLANNING BOARD TOTAL $ , - : A.B.A C.A. BOARD . . Rev. 1/03 � • 0 r � COMYX DEPA'!' OF HLUZH D��ieion oY �s�rix�ot�en4� �iaatity rt bmi COMPL=ION REP0FC 7tL, s report is to be completed be cf:ll driller and submitt, -d to Health Department, together wit laboratory report of analysis of dates• aa. -.ple indicating grater is of oatisfactor �c�erial. quality, More certificaU of coastracticn compliatce is iseued.• Well construction to.be in accordance with Bulletin SD-62 p REGL" ATIONS MATING TO nz --V=AL WAS SLTPPI.IES" LOCATION: MMCIpALrry: BOSWELL ESTATES, PUTNA VALLEY -- 3ECTIM BL=: LOT:4 WELL 0WI;M: McGlasson 93 Gleneida Ave Carmel awe r eet areas aty and T •o� WE.11 : Boyd Artesian Well Co,,, Inc' Route 52 Carmel Name, taeet. Address aty Town CASING DE:Ar's YIr= TEST WATER L, T , DE. A� Bailed ; (Measure Prom Iaad surface) Leng•t8: 255? Feet' or v ox P'J=ed .....Y 8 ilihlF'r tidticE - P '@ @t' �. 'When BailedTotal Diameter: 6 Inches'Yield: 20 d, P.M. ; or Pumped ' DrawdownFeet' L4ni�h: Pt-:54&2C mod: 19 ' t o Diameter In. TO': AL DEP H OF WE L,: 310 WE L LOG Depth Prom ' Give descriptiosi of. 8os ations penetrated, ouch as: pea► ; a . t, saad; gravel, ` Ground Surface ; elm►, hardpan, ahale, sandstone, granite, etc. Include eiae of Gael '(diam.)<. ' and,eand (Pine, medium, coarse), color of material,. structure (loose, pick d o cemented, .soft, Ixard)'o For exaucple: 0 ft. to 27 ft. fine, packed, Yellow mande 27 ft. to 934 ft. granite. 0 Ft- to 240. fit, ° Clay Overburden 24(�t,to 250 , a Soft, brown .limestone 250 310 Limestone _�` pt ` . Ft, o Ft, to Pt. AUG 3 ?t. to F r. PUTNAM F .r Boyd Artesian Well, Co., Inc. R. D. No. 5 Rte. 52 Carmel, N.Y. 10512 (914) 225- 3196 August 4, 1983 McG.lasson 93 Gleneida Ave Carmel, N.Y. 10512 I Well . Peekskill Hollow Road. Boswell Estates Lot # 46 Depth: 310' Casing: 2155' Drive shoe Tests 20 gpm �r AUG 3 19 3 DEPT . OF @" I McGlasson Builders, Inc. owner or Purchaser of Building McGlasson Builders, Inc. Building Constructed By Boswell Road Location - Street Kent Municipality 62 (Plat II) Section - Ward Block 9 Modular Frame 14 Building Type- Lot GUARANTY OF SEPARATE SOATAGE 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 des- cribed . . property, and that it_.has- bean constructed _as. shown. -on . the approved plan or- -.d ;:ed .v.... amendment thereto; and` in 'accordance with 'the` standards; rtiiles and regulations of the Westchester County Department of Health, and hereby guaranty to the owner, his successors, 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 completion 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 occupant of the building utilizing the system. The undersigned further agrees to accept as conclusive the determination of the Assistant Commissioner of Health for Environmental Quality of the Division of Environmental Quality of the Westchester 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 30 day of August 19;x.83 at Carmel, New York Place & State Signa Title e - - --, l- - - - - - - -.- - Division of Environmental Quality TnTestchester,County Department of Health. - ... January-1, 1960 i X977 PUTNAM COUNTY DEPARTMIldT OF HEALTH R DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date 29 October 1980 Res Property of McGl asson Builders, Inc. Located at Boswell Road, T. Putnam Valley Section 62 Plat II Block 9 Lot 14 Boswell Estates Subd., Sec. "B ", Lot #46 Gentlemen:' This letter is to authorize John H. Prentiss, P.E. a duly licensed professional engineer X or registered architect (Indicate)-, to:.appl�;, f .r d:"Corstr zc" - on P ermit - f' or. a separate sewerage system; to .. serve the above noted property in accordance with the standards, rules l 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 construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. 74U4 tersigned: *E, R e A e, # R. Q. 9 dd,ress 29206 Carmel; NY 10512` 914- 8794110 Te ephone Very trul: ours Signed Owner of Property 93 Gleneida Ave., SE 301981 Carmel, NY 10512 Address MkTY DEPT., OF HEALTH ;4ofESS�on� 914- 225 -7964 Telephone ss :, F� THE OFFICERS SHOWN ON THE CORPORATE AFFIDAVIT ON FILE' WITH THE PUTNAM .. '. '•r.• •M:• Jam.. _ .. BEEN CHANGED SINCE SUCH FILING. No F OA A s 6 //G (! `/ -� PUTNAM COUNTY DEPARTMENT OF HEALTH u • .` 'DIVISION OF ERVIA MENTAL "jT-i�A=11 'SERVI CES .:....COUNTY..OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN'DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. Owner %�?� G- /a sso�► �u�,[�prs, .mac: Address . ?asw e// Located at Street ; /.. 61 Block_�TLot (.n ca a neares cross s ree A ....Muni Wadtershed pP.�1 :..SOIL PERCOLATION TEST DATA.REQUIRED TO BE SUBMITTED WITH APPLICAT20NS Hole Number CLOCK.. TIME PERCOLATION . PERCOLATION RUnh apse Di-,pth to Water Water Level.. No.:,..:,...:........ ,::_:.,,:....... Time From. Ground Surface . in .Inches .... ,..'Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches .Inches. 4 Notes: l) Tests to be repeated at same depth until approximatel y equal soil rates are obtained a,t'each percolation test hole. All data to be submitted fore review.a. 2) Depth measurements to be made from top of hole. {` TEST PIT DATA REQUIRED TO-BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES..: _.. :.- DEPTH G.L. ... .. . 1J.C:a1li1V Soil Rate Used / Min/1 "Drop: S.D. Usable Area ,. provided" No. ,of-Bedr'ooms Se tid Tank Ca _p Parity /000"' . Gal s;.,:.,".* Type. .. o Absorption,Area Prov de By L. F. x24" . width trench. 4 Other 'THIS SPACE FOR USE °BY "HEALTH DEPARTMENT ONLY: Soil Rate: °'AProved Sq: Ft /Csl. C1. Date "AS BUILT° 'DATA. Orucfure located from survey by surveyor noted b'iIa Well located by: Surveyors survey•— Well drillers report —_ — _ mesur,ements�` Cq.pl,acEsh — rank, boxes, pi ?s, galleries 9 loterots located - by:.Gontrae'tor: ..f . Eno►ns`sr. a' Health dept: loan by: Health dept ®, do t e.:— iBLB .. Eng4 veer date NOTES: 4) P. ha Posvl Av" L°It -2o : 85714 V b) x \9'..D)eep P:E•s = x8-tx r= gas rns{dlle.� e �\ b i MEN "SION S R' A.- B = — — °--- A - O A - E. i_ ' tiOTs --8 _ E A F s - -G / e- F J LO TJON Street- To. SU•9DIVIS ION -:� Ma D; Sloek•. _ _ J— _ _ _ _ LOT N=�� Budder: 1►S. l:l�SSQ ,]..>`- �I Gig �.nc • � .�. �Y_i3! — -- -- — � _;.�, Surveyor: _A._._Wa.-L1" Dra>rn: IJ Date; . / w Sle:. Job Na > O H.N` H P R E N T'1.5 A P E �"� q. 4 '^ CONSULTING 'ENGINEER ,t L' =a• ;t !c