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HomeMy WebLinkAbout3638DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 74.13 -1 -15 BOX 29 r% Lti ., 16 ' JL f- Li- ' - 03638 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 CONSTRUCTfION, PERMIT FOR SEWAGE DISPOSAL SYSTEM Y == O u Cheated at —/ �• Lim .: �/"��' f.@.''���,: -�., -; , ... ,_. . _ _�.: �..d . _ - :: #b-iC. - � _ Subdivision L4 2 / 6 Lot_ �� Job _ Owner a R.1 { Address - 12 7 /<a d,&'C 1/4• Building Type f - �- Lot Area���� Number Of Bedrooms Total Habitable Space S Square Feet `. .Separate Sewerage System to nsist of Q3C� s Gal. Septic Tank lineal feet X e q, width trench To be constructed by t%S, i -.4-ir Address a` Water Supply: Public Supply From '�Private Supply to be drilled by .4rOIJ ddress Other Requ fa 1 represent that I am wholly and completely responsible for the of the proposed system(s); 1) that the .separate sewage disposal systemw r above described will be constructed as shown on the approved in accordance With the standards, rules an regu a ions o e u nam= County Department of Health, and that on completion t a ruction Compliance" satisfactory to the Commissioner of Health will{ be submitted to the Department, and a written guaran urnishe his successors, heirs or assigns by the builder, that said builder place f good operating condition any part of said se period of two (2) Years immediately following the date of the issu -'': once of the approval of the Certificate of Construct[ 1 e e ri em or any repairs t ereto; 2) that the drilled well described above r will be located as shown on the approved plan and -that I wil c ce wit he CIS, rules and regu a ons of the Putnam County Department of Health. pp pv Date 1� L =� %�.! iii• Y .. P.E. A. Address O � � o '"i,j� ' License No. 3 27 6 APPROVED FOR CONSTRUCTION: This. approval expires a ued'u less construction of the building has been undertaken and is m. revocable for :cause or may be amended or modified when cons[ ee he Co loner of Health. Any change or alteration of construction?'' Date_ requires a new permit. Ap roved for disposal of domestic sa �"" r•e. , Pri r "Ply only. By Title "'•: .... PUTNAA COUNTY DEPARTMENT. OF HEM. ACTH Division of Environmental Health Services,�tarmel,..N. ' "l OV4AJ 0P Phi Pi5'- i�fN+,f iii CERTIFICATE OF -CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM Town or village Tax Map Block 4 �7 Located at J l i l t Lot i %� Job Owner .J+� �Yi'ij ., F . ��'.'r� �...4> i-'1 ��''� 1 i✓f �� — Address 'Aw G fs.ia i� j PJLi�'S Separate Sewerage System built by k rot_ ) `. Consisting of Gal. Septic Tank and P-taf ' 1 Other requirements Water Supply: Public Supply From i Private Supply Drilled BY Address a� Date Permit Issued Building Type i. 5 1 fib a ?� / /L% No. of Bedrooms - - -- ti: a Has Erosion Control Been Completed? 1 certify that the system(s) as listed serving the above premises �yp.ewggtr�ucted essenti Ily as shown on the plans of the completed work (copies of Of H6, are attached), and in accordance with the standards, rules an filed, nd the permit issued by the Putnam County Department of Health! Q ��® <�Zi P.E. 7 ertifi� i Date ..,¢�' D i• '� 'X . _� ®r:� License No. Address e un ry to Any person occupying premises served by the ab a em �g0 "'81y� shall become null and void as so n asrea the public san�tary sewer becoimes; conditions resulting from such usage. Approve a OrD lE d ad when a public water supp Y becomes available. Such approvals are available and the approval of the private waters IY O'°is o� f H Ith, such revocati modification or change is necessary subject to modification or change when, in the �� 9 Title AOK r SHERLITA AMLER, MD, MS, FAAP Commissioner of Health dE•TTA<MOLd -AtAF� 3�P iVES1�. -. .:::. •.r. Associate Commissioner of Health Theodore Strauss 18 Shamrock Drive Putnam Valley, NY 10579 Dear Mr. Strauss: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Re: ROBERT J. BONDI County Executive _ ".....' i6nRT'IGIORRK- Ply Director of Environmental Health December 12, 2007 Addition- A- 227 -07 No Increase in Number of Bedrooms 18 Shamrock Road (T) Putnam Valley, T.M. # 74.13 -1 -15 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 December 12, 2007. 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....:A11 plumbing fixtures must be updated with water-saving devicesAi:e., new low flush - - - " - toilets; - restrictors f6r sh6iA r -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 Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health. Theodore Strauss 63 Moore Avenue Mount Kisco, NY 10549 Dear Mr. Strauss: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive . ROBERT MORRIS, PE Director of Environmental Health October 26, 2007 Re: Addition — Application Incomplete — A- 227 -07 18 Shamrock Drive (T) Putnam Valley, T.M. # 74- 13 -1 -15 Review of plans and other supporting documents submitted at this time relative to the above - regarded project has been completed. The following was not submitted with your application: 1. Sketches of existing floor plans showing existing conditions only. Plans are to be drawn _ 2. Proposed floor plan for the basement (two sets). 3. Copy of survey showing well and septic locations to the best of your knowledge. Include date of installation if known. Label all wells and septic 'system within 200 feet of the property line. Contact this office should you have any questions. Upon receipt of a submission, revised to reflect the above comments, this application will be considered further. GDR:ens Sincerely, Gene D. Reed Sr. Environmental Engineering Aide 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 J f SHERLITA AMLER, MD,-MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner. of Health ROBERT J. BONDI County Executive DEPARTMENT OF HEALTH N 1 Geneva Road, Brewster, New York 10509 14 ADDITION APPLICATION RESIDENTIAL ONLY-., VIORRIS, PE Env*ronmental Health STREET 18 Shamrock Dr.i.ve T,O Putnam Val l.ey .T��p #74.13 -1 -15 NAME H O W A R D M I R C H I N. PHONE (845)528-2601. PCHD # —� MAILING Theodore L. Strauss, 63 Moore Avenue, Mt. Kisco, NY, 10549 ADDRESS DESCRIPTION OF ADDITION Second floor addition of new master Bedroom and Bath Elimination of one (1) first floor Bedroom 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., _l_Geneva Rd,.... Brews er, -NY '-1-0509, Phone: (845) 278 = 6.130'. 1 Certified check or money order for $100.00. Sketches of existing floor plan (drawn to scale, all living area including basement) Two sets of proposed floor plan (drawn to scale -7 with name, street and tax map #) *Non- professional sketches are acceptable Copy of survey showing well and septic locations 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 Certificate of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE COMMENTS 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 KM f ' 0 Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count IZO;3Ere I: -HON ®I _:.........:: County Executive Re: 1 li' - I ��� (Owner's Name) Tax Map #: Address: Town: -i::Ll7 —k) A,AA VA L- LIE`S T Year Built: According to records maintained by the Town, the above noted dwelling, is ✓/ in compliance with .Town Code. As not in compliance with Town Code. The Legal Bedroom Count is: This information has been obtained from: Certificate of Occupancy: Other: A 35 6 SS 0Q! S 1R E' t 2� Building 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 (R45) 77R -Fina P. MrN 17Q_44AQ SHERLITA AMLER, MD, MS, FAAP Commissioner of Health 'L i E i TA "I'viOL1tVARI; RN; MgN ,.. Associate Commissioner of Health Mr. Strauss 18 Shamrock Drive Putnam Valley, NY 10579 Dear Mr. Strauss: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health December 3, 2007 Re: Addition — A- 227 -07 18 Shamrock Drive (T) Putnam Valley, TM # 74.13 -1 -15 I have received and reviewed the revised plans for the proposed addition at the above mentioned residence. Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: 1. Please provide an elevation plan for the area titled existing attic. 2. The room titled home office will be considered a potential bedroom upon further review of information requested in comment No. 1. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. If you have any questions, please contact me at your convenience. GDR:kly Sincerely, Gene D. Reed Sr. Environmental Engineering Aide Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 76558 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 Nov 30 07 09:04a a la BUILDING DEPT SHERLITA AMLER, MD, MS, FAAP Commissioner of Heafth LORETTA MOLINARI, RN, MSN Associate Commissioner of Health 9145268806 p.1 DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count ROBERT J. BONDI County Executive Re: G 14 ( M (Owner's Name) Tax Map #: '-)q'. 1 `s Address: I�Z SCI AMIf0 L L 1), 1 I y 6 Town: R —f Year Built: � Di 9 Accozding to records maintained by the Town, the above noted dwelling, is � in compliance with Town Code. iS not- The Legal Bedroom Count is: This information has been obtained from: Certificate of Occupancy: Other. Building 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 Hoene Care Fax (845) 278 -6085 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health ._ --. �,` >•. ... af+5'(. f1 ra�'�`: •�s:.v. /�.A -• -.: 5n. �'rN LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Date: f / Z 2 N /© -7 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 To: Faz7-4, D i P FAX COVER SHEET ROBERT J. BONDI County Executive' ROBERT MORRIS, PE Director of Environmental Health, Fax #: No. Pages: (including cover sheet) From: Gene D. Reed Putnam County Department of Health ZFor your ' - j ' Please respond For your review Attached as requested As -discussed . Please call Notes /Messages • c 4Z U C I In the event of transmission /reception difficulties please contact this office at efe4e-e (845) 278 -6130, ext. 2261 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 iHERLITk AN1Lr,R •1t1D AMS;•FAAP - Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 1809 Town Leizal Bedroom Count .ROBERT J: BONDI Re: 1 -F G �-} J (�� (Owner's Name) Tax Map #: 74, 3 - Address: `� a1 /vi-rz� (._ A<- � ►Z (Ue Town: 4��A 7- J -A M VA L L E j Year Built: Accordin to records maintained by the Town, the above noted dwelling, is in compliance with Town Code. :.....:, ., is., nQt _. in compliance -with Town Code. - The Legal Bedroom Count is:. , _..... This information has been obtained from: Certificate of Occupancy: Other: AS5 & S5 o2(S � O Building 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 F ,.1.. t..�Q. �,P„tinn�PrPCrhnnl (8451 27R -6014 Fax (845) 278 -664R < PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services, Carmel, N. Y. 10512 CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM JOw&.+ OF- Py ,JA j t/a r✓ir-E� Town or Village Located at 7 i-%AM iZ o cp �K. 17 P ". - .. .. Tax Map -Blocky Owner— �' i 1 1 1 t' S Lot 4 Job i Separate Sewerage System built by 1JSlr2Piir 5 Address PAw G FiZ. �`' �r7NL \P'1 Y�G4 A ;- Consisting of � %D d Gal. Septic Tank and � � � �j��' Other requirements Water Supply: Public Supply From /rivate Supply Drilled By Address PO7 Building Type ,r- 510Ed7 -1A No. of Bedrooms � Date Permit Issued Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises attached), and in accordance with the standards, rules an Date I . /-4-,0n-;, Address Any person occupying premises served by the abc conditions resulting from such usage. Approval available and the approval of the private water si subject to modification or change • //when, in the Date 7, �1 P33 -21K (3/06) essenti Ily as shown on the plans of the completed work (copies of which are filed, 4n I the permit issued by ;the Putnam County Department of Health. -q^ (fig .' / �( E!i✓ P.E. L---' R.A. �O License No. 272'L► Irc W ch action as may be.necessary to secure the correction of any unsanitary i shall become null and void as soon as a public sanitary sewer becomes d hen a public =t supp )y becomes available. ? Such approvals are f H Ith, such 1 modification or change is necessary. Title _- A 6 MEMORY TRANSMISSION REPORT TEL NUMBER 8452787921 NAME ENVIRONMENTAL HEALTH FILE NUMBER 287 DATE NOV -28 04:48PM TO 95268806 DOCUMENT PAGES 003 START TIME NOV -28 04:48PM END TIME NOV -28 04:49PM SENT PAGES 003 STATUS OK FILE NUMBER 287 * ** SUCCESSFUL TX NOTICE * ** SH ERLITA AM LYiR. MD, MS, FAAP Comm/sripy6'r pfHeo /lh LORETTA MOLtNARt. RIY. MSN Rssocic�e Commissioner of'Heal�h Dat¢• i i � 2 � /e_� 7 ROBERT .D. BONt]t Couyry Esecurlve . ROBSRT MORRY3. PS Ofrecror gfEirviroirmenla! Haollh C)EFPAFZ- rMeM-r OF HEALTH I Geneva Road, Brewster. New York 10509 >F'v3r (CC>VE32 Sy-4x-Pm From - 4 eae D_ 12eed Putnam County Department oP �Ieanith ✓ JN'or your -��� ,r�� For- your. review g ax #: No. :E!r. 03mciucting cover sheet) 7Please respolad Attached as requested As discussed Please call Not¢s /Ndessages /��.�ty- •.�/�%� �����Q�r� ,/ �. /� ]t,n the ¢vent of transmission /reception dift3cuities please Contact this ofyiice at ($4S7 27$ -6Y$O, ext. 2261 Snviron.nensal Fte..l N, (845) 278 -6130 Fox (845) 278 -7921 Water Supply Se inn (845) 225 -51 86 Fax (843) 225 -5418 M—Inig Services (845) 278 -6558 Fax (845) 278 -6026 WIC: (845) 278 -6678 Nursing Homa Care Ft (845) 278 -6085 Early X— mntion/Yr —h—1 (845) 278 -6014 Fax (845) 278 -664$ Lo-r tre A SURYEYECi 6 PFtEPAfqCo oy A , Li*ANDER BUNNEY LAp4o sustvEyole. P.C. W000SGR90GC: ROAD ROUTE 117 N16N YORK 10636 :.L7. 14- iar,t5 we o O 5)4,AMp- LOT OVP/Z Al.41"='40F -5-CrIOIV ',B'- GZOCAA40,,q,1;2-A ACRES - vdfr-, — j nor PVrA-AAoof COUNTY e4--JQtC-S 0----,fCF O'V "U' )r- Zol AS MAP N° /2 22 A aRlIZ:,y OVOC -'ITVAre /" rl4F- 7*0WAI"10FPurA,AAof VAL4EJs--- /:,u;r/v~ COZIfvrr OA rf 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 jZ,gCe,.) C.0 S,44dg Address WX /0-3,11-9 wl aP Located at (Street � x nat or,� I,.3 .:✓� °,4. r� . Block Lot %a n lca e nearest cross ss ree Municipality j d y�� t o,= Py; ,y,4rj VA1LL& Watershed f� 9 °m« SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Water Level No. Start -Stop Time Min. From Ground Surface Start Stop Inches Inches in Inches Drop in Inches Soil Rate Min. /in drop L 4 =n/ 1119 f ��i 3 •� m .5 4z- 4 It, j_- L-5 TA- 2 3 4 Notes: 1) Tests to be repeated at same depth until aroximatelyy equal soil rates are obtained at each percolation test hole. All pp data to be submitted for review. 2) Depth measurements to be made from top of hole. 26; m .5 4z- 4 It, j_- L-5 TA- 2 3 4 Notes: 1) Tests to be repeated at same depth until aroximatelyy equal soil rates are obtained at each percolation test hole. All pp data to be submitted for review. 2) Depth measurements to be made from top of hole. Address 26°K 1267 . d. THIS SPACE FOR Soil Rate Approved Sq. Ft /G�a 'W T '�c !d b Date � �-� y TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES ' DEPTH HOLE NO. 191 HOLE NO.' HOLE NO. t. 611 18" 2411 30" 36!1 42" 4 48" A .5411 If 6o" ti 66" 7211 i' 7811 84" n1 INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER /LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY L,���'. Date��� ws ...... .. .--DESIGN, , . _...� .,.... . ,. .... .. Soil Rate Used Min/1 "Drop: S.D. Usable Area Provided No. of Bedrooms r .. Septic Tank Capacity Z4 06 Gals. Type ,—e- Absorption Area Provided By L.F.x24" 5b" � %width trench. _/ 7,T Other _ �a Address 26°K 1267 . d. THIS SPACE FOR Soil Rate Approved Sq. Ft /G�a 'W T '�c !d b Date � �-� y ;u / 8 S HA r,t7-oc,tc D TZ IP UT/V4, -t Vi¢G L 6 is T - N7 T E N Z ARC prt)jeC9 ;, v e xawe�¢o r6wtnp t ale '- i I E . �X tom`[ ► r THEODORE LAURI �. /� Yyoo�a� rj