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Home My WebLink About3834DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.12 -2 -65 BOX 30 09 Ll is .. ' ;1Ir LL r � I� . oil 0 :1W ;. .. . 03834 SITE LOCATION __!a OWNER'S NAME_ MAILING ADDRESS PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEIVLREPAIR OFFICIAL USE ONLY PHONE '74S -- `17 — Chi 60 PERSON INTERVIEWED � 0(� nee- PCHD Complaint # ame a athons ip e., owner, tenant, etc. DATE (g i I c^�'7' J TYPE FACILITY PROPOSED INSTALLER ��P� j�,� �� ; PHONE ' �;— "136 -OS-1 i ADDRESS '3 k ,-6a,, RA (;,.�,.,cr' DQ REGISTRATION# 'ts --cH Proposal (include sketch locating all adjacent wells): C,0.rsY- ,t,t,n' c� » NOTE: Repair must be in same location and of same type as original se wa�e disposal system .Different location may require submittal of proposal from licensed professional engineer or registered architect. &e-& co I, as rlwner, or r ent o agree to the,eond tions stated on this four. SIGNATURE c TITLE 23MI'A Arn-� 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 ormed in accordance with the above proposal and conditions. Proposal approved pector's Signature &Title DATE COPIES: White (PCHD); Yellow (Town BI); Pink (applicant) PC -RP 99NIL Homeowner. Michael Hillis 66 Floradan Road Putnam Va114' NY 10510 (845) 628 -4363 Town of Putnam Valley Tax Map Number: 83.12 -2-65 Description of Repair to System: Installation of 120'of Pipe with 1 Y2" Washed Stone for Fields Instaner: Philip Leonforte Precision Excavating Inc. 3 Rochambeau Road Garrison, NY 10524 (845) 736 -0571 rN it 1,0c -- 3 ! q t� a' Legend: A —C =16' A -1 =31' A -2 =37' A-3=43' A -4 =30' A -5 =35.4' A -6 =40.3' B —C =25.5' B. -1 — 38' B -2 =41' B -3 =44' B -4 =10' B -5 =16.5' B -6 =22' mki t;opipiaint iF 'T. AC.ULrFYT--.5Z.,".. � -W!Vt , . , .. � , � - i I' _,,: � 1 i 9')o� V-a(-)a l.0 7 06 .. � ,� sib ►�. 6-) �- 4o Homeowner: _.. __...._. Michaef flillis 66 Floradan Road Putnam Valley, NY 10579 (845) 628 -4363 Town of Putnam Valley Tax Map Number: 83.12 -2 -65 . Description of Repair to System: Installation of Approx. 150' to 200' of Pipe with 1. %2" Washed Stone for Fields I,mo Gallo, ConCre' ,-use— C aw Z- CY-- 0 Installer: Philip Leonforte Precision Excavating Inc. 3 Rochambeau Road Garrison, NY 10524 (845) 736 -0571 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 Mr. Hillis 66 Floradan Road Putnam Valley, NY 10579 Dear Mr. Hillis: ROBERT J. BONDI County Executive November 7, 2003 Re: Addition — Hillis, Floradan Road No. Increase in Number of Bedrooms (T) Putnam Valley TM# 83.12 -2 -65 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 November 7, 2003. The addition is approved with the following conditions: _ The total number of bedrooms-must remain at Two,. . 2 :without prior -. approval -by _ _.. ....._ ._ _ .._.._ ... _.. ...�.... _........�..w_.. _..- .,...._ . 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 truly yours, Michael Luke Public Health Sanitarian ML /jp cc: BI (T) Putnam Valley Public Health Director b : . :LORET K ffOINECRI'RN. 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 FlOaL) TOWN X MAPS NAME MlIXI F, lJ c ` � PHONE qqS-- S`26:; I PCFID# A� 7Q - 0 , MI AILING ADDRESS 66 AeAJAsv DESCRIPTION OF ADDITION_ .0114 rcuft 4r. i1-),6y NUMBER OF EXISTING BEDROOMS_.6), 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 Arclutecfin 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 1009, Phone 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) *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 Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE :. Comments Feb98 BFhouseguidelines UCE R. FOLEY lie Health Director h 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)279-6559. WIC (845) 278.6678 Fax(845)279-6.085 Early Intervention (845) 278.6014 Preschool (845) 278 -6082 • Fax (845) 278.6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 October 21, 2003 Re: 66 Flordan Road.. Residence Tax Map - 93.12-2 T Town of tutnam Val 1 Py Gentlemen: According to records maintained by the Town, the above noted dwelling is xx IS NOT in compliance with Town code and the total number of bedrooms on record is a This information has been obtained from: CERTIFICATE OF OCCUPANCY: 'Rx ASSESSORS RECORD:, OTHER Building Hipector BFhouseguidelines IRV SEVELOWITZ • SU•P- 13.90 TNU 14x34 FRA,j•�s�,1�la�EN wbmmrti'�aQ'..••.c•. NOW OR f4f�ilsJERL Y �l��C _ e.;-o:" : ":;?,. 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