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HomeMy WebLinkAbout3832DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.12 -2 -62 BOX 30 Ulm rm F i L i LIE �� r r V E� j I I � �9 I � am f - II �� � �T ■,, i , ` "'� 03832 WAR -13 -2008 12:31PM FROM - ENVIRONMENTAL HEALTH 8452187821 T -880 P.001 /001 F -363 PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES. PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAI ... . ..... . . Internal Use Only _ ^PERMIT Repair Permit l3sue0 in teat 5 years G Not in Watershed I Repair within Boyd's Corners, W. Branch or Croton Falls Res, © Delegated � —> Repairwkhin 280 ft, of a watercours4 or DEC- mapped wetland Joint Review SITE LOCATION OWNER'S NAME MAILING ADDRESS APPLIOANT IMi Ie TM 4 _P ONE# �l V Name & Relationship (i.e., owner, tenant, contractor) DA's FACILITYTYPE PCHD COMPLAINT # PROPOSED I– NSTA �rv� EF LL —nY • Q,,C PHONE 1f ADDRESS ,000A I Odk REGISTRATION /LICENSE # PrUposal (include a separate sketch locating the house, property lines, all adjacent wells within 200 feet of repair and the location of existing and proposed system) NOTE: The Department may requ!re submittal of proposal from licensed professional depending on the nature and extent of the repair. s stated on this form SIGNATURE TITLE w DATE a.tJ (owner) Y"I"t I, Me septic Installer, afire to comply a �nldllions of this.permtt for the septic system repair p. SIGNATt�FIE E TITLE /L@� _ DATE p (inst8110� Rrgnosal maProved vdth the folio condition— — - 1. Procurement of any Town Permit, If applicable, 2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing: a, Owner's name, Gibe 61rest Name., Town and Tax neap number b. Location of installed components tied to two fixed points e. System description (e.g., 1250 gal. Concrete septic tank, etc.) r i!� / l d, Installers' name and phone number 3. System repair to be performed in amordance with the above proposal and conditions l k/ UL 4. The proposed SSTS repair Is considered a best fit design and there is no guarantee to the duration W which the n j completed SSTS repair will function. l� 5. No completed work Is to be backfilled until authorization to do so has been obtained from the Department, INTERNAL USE ONLY Proposal Approved Proposal Denied ❑ ; ;r :z 7 c�5 d Inspector's Signature Title Ds e < E41ration 'Date Re air propotial is in corn plianoe with appFicable codes Yea No O At:_�^ COPIES: PCH15; Ownor; Installer PC -RP 99ML Rev. 2/07 DEC -I6 -ZOOS 04:54PM FROWENVIRONMkNIAL MAW" OY Y L 1 V 1 at. 1 •. . • .. - PUTNAM COUNTY HEALTH DEPARTMENT, DIVISION OF ENVIRONMENTAL HEALTH SERVICES �Iac�ipo .1= SEWAGE: TM. ENT TEM R PAIR _. No kftniai uee Oniv PERMIT 29 iJ Rece Permit issue in lest 5 years ❑ of in Watershed G / Repair Wltnin Sco's Comers. W. &arch or Craton Fees Res. 0 Deltjawd I ' ❑ Repair u Min 20`0 t 4a watemmme or DEC-mopped wetland ❑ Joint R"eW SITE LOCATION �f �I6�4r ( � TOWN TM # OWNERS NAME PHONE # MAILING ADDRESS lorg APPLICANT d`�`Ti1V► G� fi Ifti�' . Name a Reiaefionship (i.e_, owner. tenant, oontractor). DATE )' ,r i (d Gi FACILITY TYPE Ida PCHD COMPLAINT # PROPOSED INSTAU,ER ' r " E' d _ PHONE Ott ADDRESS �b�-l��vt_o; ._ REGISTRATION !LICENSE #. � i anal Qnelude a separate sketch locating tha house. property lutes, all adjacent wells within 200 foot of repair -and the Io+Cation of existing and proposed system) NO`T'E;. The Oupartment may require submittal. of proposal from licensed protessionSl depending on the nature and extent of the.repair. -5 1C_ I, as owner;agree. to the conditions stated on this form SIGNATURE I& A..% TITLE O'l i/` DATE (owner I; the septic installi+r, agree to comply with the coed' cans of this permit far the,septic system: repair 3lGNATiJI .ltr- / j��.i� - °I iTL �S`Ji3i ,Pi ` -LATE = l finst8ller) Proposal approved with the foltagga coed' ons`. , 1, Pfa=ement of ariy TMn Permit, if applimble. 2. Submission of as built repair sketch by the septic system Installer within 3o days of Me repair, in dYpiicate showing: a. Owner's name, Site Street Name, Town. and Tex Map number h. i_owtion"of InValled Cornponet is tied to`iwp fixed points G• System delcription (e.g., 1250 gal. Concrete Septic tank, etc.) d. lnsmilers' name and phone number 3_ System ngair to be per€ormed in accordance with the above proposal and Conditions 4. The proposul SS°T'S repair is considered at pest ft design and there is no guarantee to the duration at which tyro completW $$TS repair wlfl,fun(ZorL. S, No oampletwd work is to be bac dillgd urd authorizadan to do so has been obtained from the Department INFERNA'LMSE ONLY I proposal Ap proved COPIE=S: -PCHQ; Owner; Installer PC nP 99ML Propo"I Denied ' C2 /,A/70$. D>ttte r D No C ReV. 2/07 Sheet_Lof PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION' OF ENVIRONMENTAL HEATLWSERVICES FIELD ACTIVITY REPORT Street Town State Zip PERSON IN CHARGE nR TNTF.R VTFWFT): Name and Title TYPE OF FACILITY: Signature and Title REPORT RF.CFTVFi) BY. I acknowledge receipt of this report: SIGNATURE: 02/96 T FROM : Martin Homes Inc. FAX NO. 914 621 2717 Mar. 12 2009 10:28RM P1 9 A d a v .d i d a 4f StA n ,Nph Travis 10 Corners 0 un tr c�4N South 4 A Highland 4.c 9 q own H 11 ;onvil e Cro, Corneir 14% PUT AM VA I LEY if . . . . . . . 15 1 Q537 .1 20 q !3 5 114 ., r�l 22 wm 10579• Alai TT M (Ln Ln tine Co 400 Villaoe ,wo PO I U 9 utnam LLEY co y alle OU EF E o N PO ST 'co 2. -k Mohega I , Lake r Oem 6 u d Ville 7 STREET' 7 TREE* "6RID FROM Martin Homes Inc. FAX NO. 914 621 2717 Mar,. 13 2009 01:21RM P2 .0 10 der& 4j d-2 QL ao Fos Inv, a Dater Prom: Re: To:�. -G Company: ` Tel:' 30 Page 1 of Comments:`j� �rl�/j MEMORY T RAN SMI SS VON REPORT .1 F20bf f0 :16Ah1 ` TEL NUMBER 8452787921 NAME : ENVIRONMENTAL HEALTH FILE NUMBER 013 DATE DEC -18 10:16AM TO 92842169 . DOCUMENT PAGES 001 START TIME. DEC -18 10:16AM END TIME DEC -18 10:16AM SENT PAGES 001 STATUS OK FILE NUMBER 013 * ** SUCCESSFUL TX NOTICE * ** DEC-7 8 -2008 �4+b4Pbl PROk}-I:NV l 4Oftptl:n � wt_ nnRi. � n °� -�• �• °L • '- ' • RLITIVAM CC?UPiTY HEALTH DEPARTPtItEhLT . MVlJ S10N COF EhNfFtOtvM1 =IVTAL 1- tFAtTH SER\/ICES PROPOSAL._FQR S AC3E - r%lMAT11A W-T SVSTEM lRjgPA{R y �• taeReret2tf Loo oatf pERMt't• F(Epair Permit iss:>ae In a —t 6 yo6m of U Repair VAM-40 SmIoWm Camas. W. 8WOnCr Or C--.r.. V-, _ 7M Rt R. _. Ek�llfal, ii Repair vwAi4i li0 tt era �eatnrasur..e ar DE^ •^- -ped .reUamo [� Jofr SITE LOCATION r- Its., TOWN A &NZjcL e:. Vr-I i¢-y TM tv - t7WNER'S NAME PHC)NE,ri ��S- "�+�- S ^G3C�Jp� MAli.1NQ AO� ESS _3Y 1Di' evt {• cr^•. /Ge . -��/. /6_C'74 - .t.tam 6 >aatator+ trap R. CA. e,r_ te:.ar+Lce-a!�.tr 41 . DATE {e�> {� - -d% FAGIL(TY TYPE {l�a¢xCt¢t PCHO CatytPt_AiNT it ' PROP03E0 INSTALLER �,��r Y�4J- � � b PHONE ?I ��YS � �'x1$� 0qEC3tSTFZF.TtON ogii; 1S& 7F . v • ETjaoasal (}nclude a meparata slc®tC7f loOM"ng thO hawse, OrOperty IInCS, ail adjaCent walls within 1-co t"offt of repair and the Io=suc." of ema- -S iris 'snet prcb1psssad symtont) . NOTE -.. The Department may require submittal t f propo%ml From ll=onse3d protesslonal depending on tno nanire and ee meni of tree rgpatr- �d-G�a ti �-• -Y -- i''L.�L P ��r% •P �C�. r}er�•- is 1. aS dwrmr,a19ree to ute condtdorts stated on thle f4ocrn SiGNATU RE / �eCi TITLE y/�p/- DATE I--;t - /.-- _ dQ (ownaq I, the SOptJc Inst812Cr. ayg"re6� t0 oOmply�wi�th the cortCttlPn6 of thi9 parrrtTt 76r the sbptlC Sys29m, repalr TITLE (installer) Prop@ ril o -rovod It the iono 9t11Te cond'afrm; 1. Procurermort of earay -clown ?artittt, if aPPSICable. a. $utarrtlCelon of am built —licir siceCCh by the M.Ptic `Yaa-m SD doyw of itta repair• In OUP11CatB shglMrin9- a. C]wricr'a mama. cM& Street Narrtaa. Town and Trost Map number . b Lccatton- of intatailed oomponerms tied to two tisced points a. . System Oe ,,iptior, (e_gs. 't.M.4o cWL Cur.ea[B taptie taritc, d. Insapars' rz rte arrr3 Phone number . a_ System ropeir to be perfermaed in accenlanca .. ftft 'dhe abova propoie¢et end r rtdwons 4_ - -rho proposea SST rmp"Ir Is oOnmlrlereo a bas's ffi aomMra ariA tnvrc i3 no guarantee m ttim durcteor. at whim•. tare — ptestowd SS-rS repair whi.YUnCgor, 5. rte wmplat-o wont is to be tratddtlt Lwait avthorfzatton to do ao has beers obtained From •9se DeParlrsianL n rT> +wsat_ LPS5,15 ON Y Propomai ^pprovmd Propo6a?at Denied 'd r __ _ �,�•.a _ anatura 13t Iris T?atea _ isxpirahon Data COPIES_ -POHD:Owner:Installer - f�G -rqP SSMC SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Arthur Defeo 5 8 Floradan Rd. Putnam Valley, NY 10579 Dear Mr. Defeo: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 May 11, 2006 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Addition Approval, A- 079 -06 No Increases in Number of Bedrooms Defeo, 58 Floradan Rd. (T)Putnam Valley, TM #83.12 -2 -62 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 11, 2006. The addition is approved with the following conditions: I., The total number of bedrooms must remain at two 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. - 4. This Department recommends you contact your local Building Department to ensure setbacks and other current codes can be met. 5. This 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. GR: lm cc:BI (T)Putnam Valley Very truly yours, - — - — ^ L�' -- Gene D. Reed Senior Enginering 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 InterventiontPreschool (845) 278 -6014 Fax (845) 278 -6648 -0-0010 �o m 01® nz6o ® � -- 7a 0 -� z CA LA o u rrl o �0 z w Co 0 0 8 3 • o` btunuuiwa ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE HOUSE PLANS PMUST'BE SUBMITTED TO THE PCDOH FOR APPROVAL ai 4� t E ITURE & TITLE D TE z 2 I =o f � � >m 4 9" pp�q 4' t.. n., c� 4 NOW OR FORMERLY LENORE OLSHER ' tOQCOr A !TE X n �� �) co �- n t ' I i i law ® 8T8 71'8 t NOW OR FORMERLY I JOSEPH GIAIMO PUTNAM COL1i'1T`r OF HEALTH HOU4iE PLANS APPROVE -D FOR BEDROOM COUNT ONLY o` btunuuiwa ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE HOUSE PLANS PMUST'BE SUBMITTED TO THE PCDOH FOR APPROVAL ai 4� t E ITURE & TITLE D TE z 2 I =o f � � >m 4 9" pp�q 4' t.. n., c� NOW OR FOR BURGHETTA FLORADAN ROAD SITE PLAN I /1s° _ ARTHUR DEFEO AND DOREEN SEWEL RESIDE14CE 58 FLOPMAN ROAD PUTMM VAU", NEW YORK-lom EXISTING FLOOR PLAN iYi o iP��6 u Amt am= an 41Lr1 gym} pub p� MM WE mm ' ��tWp �OFy� �Sp yy��M�.� f1A114P m RMiL J ^r^ C LAWM sod arc � � � ©W C7 � _M 00: 7 ZOO 3z� Zow V` W Zt cr'r" Li- p iJc� - . k rya M mar s FLORADAN ROAD SITE PLAN I /1s° _ ARTHUR DEFEO AND DOREEN SEWEL RESIDE14CE 58 FLOPMAN ROAD PUTMM VAU", NEW YORK-lom EXISTING FLOOR PLAN NOW OR FORMERLY BURGH ET FLORADAN ROAD SITE PLAN ARTHUR DEFEO AND DOREEN SENEL RESIDENCE 58 FLORADAN ROAD PUTNAM VALLEY, NEW YORK 10579 EXISTING FLOOR PLAN WA Wr XXk am= MR= aw mw 4W ToM av mum 1.24W La OF Dow 4[ffi! VIIAtI w Am _ ta-0' T _ adsrt{�i�f/ Kt% �e� O } ocQl> zoo CL �ruMC> l i ^3�c�� ZCOr^ J O I '> r. mar QfGr-aw FLORADAN ROAD SITE PLAN ARTHUR DEFEO AND DOREEN SENEL RESIDENCE 58 FLORADAN ROAD PUTNAM VALLEY, NEW YORK 10579 EXISTING FLOOR PLAN b SHERLITA AMLER, MD, MS, FAAP - Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive KDEPARTMENT OF HEALTH ; 1 GenevaRoad; Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY STREET TOWN'�u� e TAX MAP #� NAME � U��''�'Y�CJ� � GPI c� PHON `� S1 �-� ' PCHD# — - MAILING ADDRESS DESCRIPTION OF ADDITION C V NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS a cvyl (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR J "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„ Geneva Rd, . Brewster, NY 10509, Phone: (845) 278 - 6130:- .. 1. Certified check or money order for $100.00. 2. Sketches of existing floor plan (drawn to scale, all living area including basement) 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 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 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 fki O SKERI.ITA AMLER, MD, MS, FAA.P - : ,.... Xx r:issioner of Health;_ 1LORETTA MOLINARI, RN, MSN Associate Commissioner of Health RODERT d. RONIDI .• -.. , � � �- .. - ... , ...:Cowcty Earecutive .. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 PUTNAM COUNTY DEPT. OF HEALTH 1 GENEVA ROAD BREWSTER, NY 10509 Re: 58 Flnradan Road Residence TAXIVIAP# 83.12 -2 -62 To Whom It May Concern: According to records maintained by the Town, the above noted dwelling, -- IS - - IN COMPLIANCE WITR T® CDIDE. -. .. . IS NOT IN COMPLIANCE WITH TOWN CODE LEGAL BEDROOM COUNT IS 2 This information has been obtained from: CERTIFICATE OF OCCUPANCY: ( see attached). OTHER: uilding Inspect Date CERTIFICATE OF OCCUPANCY Water Supply, Section (845) 225-5186 Fax (845) 225 -5418 Im Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC(846)278-6678 Fax-(945)278-6085 FR.1. W�e�+•veenNnsu/9►rocrh�l (RdS1 77R -((114 Fax (RdSI 77R- fi(•dR NOW OR FORMERLY BURGHETTA. FLORADAN ROAD 7 SITE PLAN fl-l16 = 7--0" ARTHUR DEFEO AND DOREEN SENIEL RESIDENCE 58 FLORADAN ROAD PUTNAM VALLEY, NEW YORK 10579 PROPOSED FLOOR PLAN AIWA nor Xwk. Mm auum 16V Buum TOM 1v mum LW Of 00SM RNtD} UM WAM PRINUM ADQ1= s rr serf . Mf 4mf 1."m -d r C � �` r a O y, � N ��rMpf{,AT���wON �"'.m 1RiY J O W 0 W C7 ® [Z• ZOo 0w5- Z O LW W FODTP�R Of fiC11SE ®�e+aew FLORADAN ROAD 7 SITE PLAN fl-l16 = 7--0" ARTHUR DEFEO AND DOREEN SENIEL RESIDENCE 58 FLORADAN ROAD PUTNAM VALLEY, NEW YORK 10579 PROPOSED FLOOR PLAN "Dal! .. Y...�....1..? ......... 19....1! f TOWN OF PU T lt"` AM VALLEY N°-1q 02727 Zone District ................. ....J.................... PERMIT RECORD I LAND Application is hereby made for ..... ........0 Permit Work to start.....L14:X.- ...n.4.. ,. ........ Description ......... ... .. (k3 .1 ty .� _ ........... � ................ ............................... j'� 1 �' 1 .............. `-........ ............................... .......... .. ... .............. ............... Location of Premises — Street or Road .. �o.l�u ..... ...:......................................................... ................ /..1........... ..�........6..r.. .. SEC .................... I...... BLOCK ............ _............. LOT ........................... FRONTAGE Depth........................... Rear ........................... ACRES (other description) or numb©r of square feet ............................................... :.................................................. _................................................................. SUBDIVISION NAME ... .4 .. ................. ........... .: ................................. n.................._. ...... ....................... TEL............... ............................... OWNER .. ............................... ADDRESS ..R .P.r" 3 �.......1...:... �......:.. ........... 7 I Log %.awn 1 I arICK t I r:l. . I r,:9_1 CERTIFICATE OF OCCUPANCY Dimension of Building Width . Depth Stories ' ertificate of Occupancy No....:'.74 .954 ........ Application No...�4r f7 �7(Acido &0.pen Deck) ,ocaiion of Premises ........... ... '�,q sc3$n i2d ®Q.. r 1oradan Lod .e ....................... iEynnour �i� non ............................. of ..........r'tttau�m �t Valley, Y ®....................... having eretofore filed an application for a building permit pursuant to the Zoning Ordinance, Sanitary !ode and the Laws in effect in the Town of Putnam Valley, Putnam County, New York, having aid the required fee therefor and the undersigned having by personal inspection ascertained that he applicant has subsequently proceeded with the erection or improvement of the proposed struc- ure in compliance with the requirements of the laws as aforementioned and that the said work nd materials met every requirement of the laws as aforementioned and that the premises have low been . fully completed and. are ready for occupancy pursuant to* the provisions of law, Now, herefore, this certificate of occupancy is hereby issued ..under the seal of the Town of Putnam (alley this .... I>?th...: day of ..... Giiiva ..............1 19....7 dot valid unless signed in ink by a duly authorized agent TOWIq OF P NAN VALLEY.WEW YORK if and xinder the seal of the Town of Putnam Valley. i roe i ..............:7 a............ Building $ ..... ............................... Sanitary $ ..... ............................... Plumbing 5 ..... ............................... Well Estimated Total Livable Area ......... ............................... Cost.. Date Zoning Board Approval ............... ................. Per Iuired m0.- .0.00 . d - . ., GENIM MNAGI:R COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED ICI ANY MANNER. Ta. yr A 'bUftVBYUR t S lYltiP . ND F�PLETE PUNS ;M SPECI.&TIONS �.LL INFORILLTION REQUIRED * BY THE jONING ORDIN.LNCE a�ND SjjNRY CODE MUST BE SHOWN BELOW OR ON THE 1EVERSE SIDE OF THIS. &MI.CL.TION O r, i USE CONST. ROOFING I LAND t Family Wood Wood Shingle IP&vGd 2 family I steel Asb. Shingle Join, I Log %.awn 1 I arICK t I r:l. . I r,:9_1 CERTIFICATE OF OCCUPANCY Dimension of Building Width . Depth Stories ' ertificate of Occupancy No....:'.74 .954 ........ Application No...�4r f7 �7(Acido &0.pen Deck) ,ocaiion of Premises ........... ... '�,q sc3$n i2d ®Q.. r 1oradan Lod .e ....................... iEynnour �i� non ............................. of ..........r'tttau�m �t Valley, Y ®....................... having eretofore filed an application for a building permit pursuant to the Zoning Ordinance, Sanitary !ode and the Laws in effect in the Town of Putnam Valley, Putnam County, New York, having aid the required fee therefor and the undersigned having by personal inspection ascertained that he applicant has subsequently proceeded with the erection or improvement of the proposed struc- ure in compliance with the requirements of the laws as aforementioned and that the said work nd materials met every requirement of the laws as aforementioned and that the premises have low been . fully completed and. are ready for occupancy pursuant to* the provisions of law, Now, herefore, this certificate of occupancy is hereby issued ..under the seal of the Town of Putnam (alley this .... I>?th...: day of ..... Giiiva ..............1 19....7 dot valid unless signed in ink by a duly authorized agent TOWIq OF P NAN VALLEY.WEW YORK if and xinder the seal of the Town of Putnam Valley. i roe i ..............:7 a............ Building $ ..... ............................... Sanitary $ ..... ............................... Plumbing 5 ..... ............................... Well Estimated Total Livable Area ......... ............................... Cost.. Date Zoning Board Approval ............... ................. Per Iuired m0.- .0.00 . d - . ., GENIM MNAGI:R COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED ICI ANY MANNER. Ta. yr A 'bUftVBYUR t S lYltiP . ND F�PLETE PUNS ;M SPECI.&TIONS �.LL INFORILLTION REQUIRED * BY THE jONING ORDIN.LNCE a�ND SjjNRY CODE MUST BE SHOWN BELOW OR ON THE 1EVERSE SIDE OF THIS. &MI.CL.TION O r, i NOW OR FORMERLY BURGHETTA FLORADAN ROAD SITE PLAN 1 /16° 1' -0° ARTHUR DEFEO AND DOREEN SEMEL: RESIDENCE 58 FLORADAN ROAD PUTNAM VALLEY, NEW YORK 10579 PROPOSED FLOOR PLAN AMA SUMN nor Aran: &w" EXSW aNAW Mf TOTAL !y mmm 1."W , (�I WE OF SSW ti FOtIMIM WALL m mmm 1Srr I mv �ll V r-or _ V BE GMT ON $ o O:f J OwJO €3 Owl ® w _ • ZOO ZOw LL- Z w O J —� F009PM wear s xes -�sar FLORADAN ROAD SITE PLAN 1 /16° 1' -0° ARTHUR DEFEO AND DOREEN SEMEL: RESIDENCE 58 FLORADAN ROAD PUTNAM VALLEY, NEW YORK 10579 PROPOSED FLOOR PLAN NOW OR FORMERLY BURGHETTA AttEAttat�t Wr Atha r Emsm Laium air ww SULO ac 40bf TOTAL AM emits 1.2e0d UK 'IF L90SLpLG FOLD M WALL TA mer ®maw FLORADAN ROAD ' SITE PLAN 58 RORADAN ROAD I PUTNAM VALLEY, NEW YORK 10579 EXISTING FLOOR EXUMG-/ L.il WOOD o lY J J C) OECD( 4 p CL' CL .�) _Q Ow <5 61 LLJ zoo ZOO Z LL- O J FOOiPM OF a, mer ®maw FLORADAN ROAD ' SITE PLAN 58 RORADAN ROAD I PUTNAM VALLEY, NEW YORK 10579 EXISTING FLOOR SITE LOCATION OWNER'S NAME,t MAILING ADDRESS PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES OFFICIAL USE ONLY J -0.3 (2-p TM# O c3 , 1.2 6...- -�-1 PHONE .1 r PERSON INTERVIEWED d1o6104r;RI S PCHD Complaint # ame a ations p i.e., owner, tenant, etc. TYPE FACILITY Q DATE '-�� —D 3 AE$- , PROPOSED INSTALLER PHONE Q <, o / �- ADDRESS 6A-%- _, REGISTRATION# Proposal (include sketch locating all adjacent wells): 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. 1, as owner, or a ort d agent of owner agree to the conditions stated on this form. SIGNATURE TITLE DATE Z�3 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. Inspector's Signature & Title COPIES: White (PCID); Yellow (Town BI); Pink (applicant) PC -RP 99ML 4 DATE ti ........... Al 7-ID ........ . .... . ... .. -.1.1---, li—.0 1 c ............ . -SX111 SY FGU�U 44 /V P4-fg S V�PIT DATA "i 291000 DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH .. _._ �IOL1✓"•NO. - :�. HOI.:NO: ,E G.L. 0.5' 1.0' �fi4'`%)V 1.5' 2.0' 2.5' t � 3.5' 3,5 4.0' 4.5' 5.0' 5.5' 6.0' 6.5' 7.0' 7.5' 8.0' 8.5' 9.0' .. 9:5... . 10.0' l� Indicate level at which groundwater is encountered Indicate level at which mottling is observed / ,-) /.V� Indicate level to which water level rises after be' g encountered Date Dee hole observations made by: ;l C%T S C , Design Professional Name: Address: Signature: [u l N 4 " Design Professional's Seal cz:—1 ?f r.~r 4 2 "�+(`'aF; ... • 2 .�.: -,a' •-r � i+: . i, r"E . r:. �,:* �yrb�• �.�•r fE � Y 3[ r1 a }'a y '� ,,. � ♦ $:.' A,y t -; r+itc � �.f `�� •.. .max. ! ��� �'$p- - .w.. ��`'}< i`` .ry '. ri'.. �,� �f} a• f• _ a -` #.� a tt -t-r9 to _'ice' '•5-., � �G: � t f x'�,.5'' ''-� 3C rin �•, ♦fi,�,�� 'S -^T' � b'> •�.� :�i� . - - - :+�..._ x, s cN ,.��.t:'::.f 3•'�- ._•,!a54 -_ <'' +`` "� a =��,s3 y Y .r .r :..,_y . , �t;:; t ��'� _ - rr. - °. ...a�D't'lj�,. 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