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HomeMy WebLinkAbout3835DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdoes.com 631- 589 -8100 83.12 -3 -2 BOX 30 ;�■ I jLT . ,.4.6 f fir. '. t' .. 03835 1 <7) n PUTNAM COUNTY HEALTH DEPARTMENT. Etat� ° DIVISION OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAIR N internal Use Only PERMIT ❑ Repair Permit issued In last 5 years ITWot in Watershed ❑ Repair within Boyd's Comers, W. Branch or Croton Falls Res. a Delegated ❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION �� �? ' � TOWN, i1,y��AMV L L L F-� OWNER'S NAME PHONE# 472 9- 319,V MAILING ADDRESS ( ;f Le AA-4 019 N RJ? I :�.V a (l1 44A Ti T L, "'- r I Ag APPLICANT O u 14f-P ((2-&C f," A ' 1 Name & Relationship (i.e., owner, tenant, cxtfitractor) DATE FACILITY TYPE PCHD COMPLAINT # PROPOSED INSTALLER tw T FS f raft -D �C'��T .% PHONE # sY �;S' e'aG. 39 i ADDRESS V , .A-7�� AL -r- k, �`.L� REGISTRATION /LICENSE # /) c�^S"? r Pro sal (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 require submittal of proposal from licensed professional depending on the nature ang_extent of the repair. I, as owner,agr t the conditions stated on this form SIGNATURE TITLE 0 r<V :jY gr\ DATES Z z (owner) I, the septic ins Iler, agree to comply with. the conditions of this permit for the septic system repair SIGNATUR • - i% --ik � TITLE a r r—hN t. DATE EMggjW with the following conditions: 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, to duplicate showing: a. Owner's name, Site Street Name, Town and Tax Map number b. location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the completed SSTS repair will function. 5. No completed work is to be backfl ed until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved Proposal Denied ❑ drpector's SlIg nat ire & Title Date" ratio ate [Repair proposal is in compliance with applicable codes Yes No ❑ COPIES: PCHD; Owner; Installer PC -RP 99ML Rev, 2/07 L� DEPARTMENT OF HEALTH bivlsion of Environme„tal Health _Services 4 Geneva Road Brewster, New York 10509 W. (9 11) 279 .6130 Fax (914) 278 - 7921 BRUCE R. FOLEY Public Health Director NO qd ..••• r :rr • • r M• 6t STREET -O aKDNJ __Ql7 TOWN V TX MAP # 3P _ 3 NAME S Yh 1-T-H PHONE_ PCIID # a MAII,II�'Cr ADDRESS / � 2(� f� �i3 ii k A� -0 V DESCRIPTION OF ADDITION P_ 'AJC10SI;D P(gkw � F1021' DA ��'► N.UNBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS„+ , (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM 8UILDMIG INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a Professional Enaineer_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 Rd., $ rewster, NY 10509, Phone 27$ -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. QFF1C.'E USE Comments a BRUCE R. FOLEY Public. .Health Director:__., DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278 - 6130 Fax (914) 278 - 7921 November 13, 1998 Patrick Smith 61 Floradan Road Putnam Valley, NY 10579 Re: Addition - Smith, Floradan Road No Increase in Number of Bedrooms (T) Putnam Valley, 83.12 -3 -2 Dear Mr. Smith: 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 latest revision date of November 12, 1998 and this Department's approval stamp. Based on the information submitted, the above mentioned addition is approved with the following conditions: -- J -1. The total number of bedrooms must remain at two without prior approval by this - _... area Fof the'exisling 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. Approval is granted for sewage disposal only. 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. W e 1y yours, Bruce R. oley Public He th Director ML /jp cc: BI (T) Putnam Valley cr 0r REA L TH TIOUSE PLANS orl Da PUr"'dJA if CO '.—Y Sin PI .-I - q, ICIT U E' PL A -P B rat C, U, -3, 3 - 2- 3Y. P UD.Vi,:v-1 c 0 11OUSE PLAN" OF HEALTH BEDP�00,,,j Co" Fo,� RZAIMFAW� ��MMAW S3 12 _3_Z i 3 I w/H ► .c:z- I ;i�dI'le9 E3 OF HEALTH -- (�. Vt MiMML Cl /\ WAR p •' •. ■ 'ov��, 9-60 - f 15' L V, Iv6- R00 m &Rpt 5s, ■fffWJIWAW IkM CQ r - f 15' L V, Iv6- R00 m &Rpt 5s, ■fffWJIWAW IkM CQ Application No...... .......... APPLICATION FOR BUILDING PERMIT _ Plan. " TOWN OF PUTNAM VALLEY : Zoning District.: it l " � 11 1 NAME of.Owner_::!1_!i N.!F.l ....Y�1...4.R.6.R 6 -R •-=-= - - -P.. 0....__._PU.-_ I A.!h... V .. t . �. ........ M LOCATION: of Premises: Street or Road.._______._ F �nQ.t P-_9-N...._..... ............................................... Block' No ................................. Lots No .................................. Side of Street - - - -- . o u r H.----- - - - - -- ';LAND Number. of Acres ....... .............................or —Number of Square Feet ....................... ._........... i In feet show: Frontage._.........4A ....... .. ...... Depth....._.._..../00 ...._... Rear ... ........ ! Other d es cription ----------------•-----•------._.._...._..------•---•-•---•-----•-.._...-----•-•-•-------•-•--------- BUILDING: to. nearest foot show: Overall width ....... 3-y....... Depth ........ X_Y-..... Height ...... fl........ ':Kind of foundation:_ ..... M.A.Ao.0.1i ........ ° :::.:... .....Type of building ............................................... �r Show size and use of each room; together with window area ........ ................ I ......... I................. J SEWAGE: Type ......... ......So- O_-_•____Size of Septic Tank..; ......... o - °..... gallons.................. - •_.__...... i�. p Lineal feet of 'field drainage ..... ..............................: :.Size of dry wells ............................ :Building permit issued and fee paid ...............•--......------------ •- •- ••-- ••---- -• -• -- ---•-•- •-- •-- •._..........- •- •- • - -• - -• :Fee paid for Certificate of Occupancy - -•- •-•--------------------------•-•-------•------_....------ ..........-- •- •----- • -:..• ` Occupancy Inspection made ......................: i; • -- ••----------------------- •-- -- •- ••- •......- •-- -- ......_ Certificate of Occupancy issued .... ... ........ ... . .--- • -• - - -- -� SI NA I' ,RE of Applicant_ -.__.. � .....P. 0......._ RECEIVED ..............:....... ..... .194_ _ UNLESS ',THIS APPLICATION IS ACCOMPANIED BY A COPY . OF . A SURVEYOR'S MAP AND COMPLETE .. PLANS AND SPECIFICATIONS, . ALLw INFORMATION REQUIRED BY THE ZONING ORDINANCE AND SAN - '' -ITARY CODE. MUST- BE =SHOWN :BELOW'•OR ON THE REVERSE SIDE. OF THIS APPLICATION. 4 ' i 9 r r/ �*- `), o ;l&) P. I A IN s a � C ^ - � •r /�r�er y %iten�ouin ............ �.I� ..k: masse n a . J 23`1 ?;ism: \ co Worn fyf, W l t; n►, ell Rider* which,rray be vised;With Standard- BTU'F0im 8041, rev. 11/78 SCHEDULE A (Description of Prerpises) All that certain plot, piece or parcel,of land, with the buildings and improvements thereon erected, situate, lying and being in the Town o f Pu. t n am Valley, Putnam Co u n t y , New York, bcing wore part "icularly:'bouttded a•n¢ described a� foltaws: BEGINNING at a point on the southerly side of Floradan Road at a point to be.deterntined by commencing to measure from the large Rock at the northeast corner of'premsles formerly owned by Daniel M.' Rader and- located - at . or; near Oscawans Brook; and RIMING THENCE In a northwesterly direction along the boundary line of the lands formerly owned by Florence Schwartz and adjoining-the Burchetta.property 1067 feet; 'IRENCE at right angles in a southwesterly direction a distance of 140 feet; said:point also being distant 100.00 feet westerly along Floradan`.Road from theWesterly side of Violet Street'at the northwesterly corner:..of.ladns now or formerly of Flohr; RIMING THENCE along said lands of Flohr South 230 22' West 100.00 feet; RUNNING THENCE North 66° 38' West 60.00 feet to lands now or•formerly of Tenenbaum; RLM I IVY THINE -a -i -o n-g —t-h e s eme North 230 2 2 ' East 100.00 - f-e- e-r—t -o � i l o r n d a n Road; RU NING:THENCE -al- ongt"; the: same-_Sbirt-h-66 38 East .60.00 p- fcet.:.c -a- the vp'oint °of 'BEGINNING. BEING the'same premises conveyed by Daniel M. Rader, by deed dated September 3rd, :1952, and recorded September 4, 1952 In Liber 415 ep 299," in the office of the Clerk of Putnam County, State of New York. 8 THOMAS SCUCCIMARRA : THENCE along 22' .West - I. n o RaNld i rv�i - One Souih Dlwslon Street . s ' P:O Box` 72 �ti < : _ Peekskill,Jgeib York 10566 r ` THENCE along f } _91443976'05 0 • < t DF. 00 �k o oW1 ME ii" , U01 - Z;Standard NN.B.7 %U: Form 8602 -2DM — Bargain and Sale Decd with Covenants against Grantors Am— Individual or Corpusatiun. (single sheet) CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT - THIS INSTRUMENT SHOULD 81 USED BY LAWYERS ONLY xa THIS INDENTURE, made the t _day of , nineteen hundred and .n i n e t y BETWEEN SAMUEL S. REISMAN and CELIA REISMAN, his wife, both residing at .61 F l o r a d a n Road, .P.u.t n am. Va 1. 1 - - -_ flew— Yo- r.k._...._- 1 1! paity.gf the`first part, and. JAN 2 3 ;c91. S`PATRICK' SM17,H, residing at 7 Contitutiorl Drj'ive, Cold Spring, New York party of the second part, WITNESSETH, that the party of the first part, in consideration of ten dollars and other valuable consideration paid by the party of the second part, does hereby grant and release unto the party of the second part, the heirs or successors and assigns of the party of the second part forever, ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Town o f Pu t n am Va 1 1 ey, , Pu t n am Co u n t y, New Yo r k , being more particularly bounded and described as follows: BEGINNING at a point on the southerly side of Floradan Road at a point to be determined by commencing to measure from the large Rock at the northeast corner of premises formerly owned by Daniel M. Rader a.n- d- 1_o- c- a- t- e'd —a -t o- r— n- e- a- r— Os-c -awa n�k ; RUNNING THENCE in a nor thwes t -er -1 y._­d i rec t i on- .a j.:ong: t .he.hounda,ty=- 1fne- 'of- t•h -e•- lands -formerly ' owned by Florence Schwartz and adjoining the Burchetta property 1067 feet; THENCE at right angles in a southwesterly direction a distance of 140 feet, said point also being distant 100.00 feet westerly along Floradan Road from the westerly side of Violet Street at the northwesterly corner of lands now or formerly of Flohr; RUNNING THENCE along 22' .West - I. n o RaNld i rv�i Y1�L1VC..L__- iYG_a__c,ar_ now or formerly of Tenenbaum; RUNNING THENCE along feet to Floradan Road; RUNNING THENCE along f BEGINNING said lands of Flohr South 23° the same North 23° 22' East 100.00 the same South 66° 38' East 60.00 feet to the point o Together with the right of ingress and egress, in coinrrion with others over Floradan Road to and from the nearest public road. remises as conveyed to BEING AND INTENDED to be the same p d from Esther Sar_-cuel S. .Reisman and Celia Reorded,7 /12 /72einytheePutnam County. Sandelman dated 7/5/72 and rec Clerk's Office in Liber 702 cp 490. TOGETHER with all right, ribed and premises ses toy the center lines thereof the with the appurtenances roads abutting the above describe p ights of the par r, ty of the first part in and to said premises; TO HAVE AND T _. _. .,art- the heirs or successors and assigns of 372800 PUTNAM VALLEY 61 FLORADAN ROAD OWNER & MAILING INFO — SMITH PATRICK J 7 CONSTITUTION DR COLD SPRING NY 10516 NYSRPS ASSESSMENT INQUIRY DATE : 11/06/98 SCHOOL PUTNAM VALLEY ROLL SEC TAXABLE PRCLS 210 1 FAMILY RES TOTAL RES SITE 1 kL, com, S11 ACCT NO. 181510 MISC ASSESSMENT DATA RS - SS ** CURRENT ** RES PERCENT 1 LAND 20,600 ** TAXABLE ** BANK TOTAL 102,300 COUNTY 102,300 C040200 ** PRIOR ** TOWN 102,300 LAND 20,600 SCHOOL 102,300 TOTAL 102,300 — DIMENSIONS FRONT 60.00 BOOK 1111 DEPTH 100.00 PAGE 00084 EXEMPTIONS SALES INFORMATION SALE DATE 12/01/90 SALE PRICE 109,000 PR OWNER REISMAN SAMUEL S & SPECIAL DISTRICTS CODE AMOUNT PCT INIT TERM VLG HC OWN CODE UNITS PCT TYPE VALUE IFDO14 TOTAL EXEMPTIONS 0 F1 =NEXT PARCEL F6 =G0 TO INVENTORY RPS075S1 SUBJECT 372800 PUTNAM VALLEY SMITH PATRICK J 61 FLORADAN ROAD TOTAL SPECIAL DISTRICTS 1 —J F3 =NEXT EXEMPT /SPEC F4 =PREV EXEMPT/SPEC F9 =G0 TO XREF F10= RETURN_TO'MENU 11:26:0.8 RESIDENTIAL SITE 83.12 -3 -2 PARCEL PRPCLS 210 TOTAL TOTAL RES SITE 01 PRICE 109,000 VALID PROPERTYaCLASS 1 FAMILY RES ZONING R1 SEWER PRIVATE WATER PRIVATE UTILITIES ELECTRIC NEIGHBORHOOD 83302 INQUIRY 1 FAMILY RES RES SITES 1 COM SITES 0 DATE: 11/06/98 ROLL SEC TAXABLE LAND 20,600 TOTAL 102,300 RESIDENCE BLDG. STYLE COTTAGE YEAR BUILT 1950 EXTWALL MAT COMPOSITION..., :STORIES ... _ 1.0 GRADE,_,: -: AVERAGE , AREi�;S HEAT TYPE HOT WTR /STM 1ST STORY: 834 NO. OF FIREPLACES 2ND STORY: NO. OF BATHROOMS 1.0 1/2 STORY: NO. OF BEDROOMS 2 3/4 STORY: ATT. GAR. CAPACITY FIN BASMT: BAS. GAR. CAPACITY TOTAL SFLA: 834 TYPE SIZE1 SIZE2 QUAN TYPE FRNT DPTH ACRES SQR FT 01 PORCH,COVER 156 1 01 PRIME SITE 60 100 TOTAL IMPROVEMENT ITEMS 1 TOTAL LAND ITEMS 1 F1 =MORE ITEMS F6 =ASMNT INQUIRY F10 =G0 TO MENU F4 =NEXT RES SITE ON FILE F9 =G0 TO XREF RPS075S2 11:26:11 Date 19 ..... TOWN OF PUTNAM VALLEY Application f j APPLICATION FOR BUILDING PERMIT. Zone District . �....... . Application is hereby made to erect (alter) ...I. alq .. .................. :.Work to start 40'r ... . Building ...... - :r� .- .'..... ........ .... ..... ... . Location of Premises — Street or Road :... '.: . (e��. . SEC.......... BLOCK ........... LO I: 1 : .... FRONTAGE Depth j00 :... Rear. ACRES (other description) or number of. square (feet ........... /' ....` ......... . �.. .. I` ... .... <. ................ OWNER to �"!•.� ... ` ....ADDRESS tl".' ":l/* .......... I - D' fJB 'Idi I 1 � ILK i j Imenslon o ui ng Width Deptb Stories i2 .3 F" Q;QrC X X X X X Type foundations ... Size & use each ......... ... . Room with window area ........... .... ... ........ . Sewerage type "7 � ... ...... . Size of septic tank .'�'.�:.. . Lineal Ft. Drainage .. %f %........... Size of dry wells ......... .. . Additional informatio • ........ _..... /`V 111W •- . .. .ZA r bier -• I: ... ..... .......................... ........ .... This application must be accompanied by copy of�surnge ors mop and complete plans, specification, and all information required -:by - .Zonin Ordinance and Sanitary Code when requested by inspector. �} 1 i I, ......... .. .���` .. I . .. the applicant do hereby.certify that the above statements are true to my knowledg -and belief. Fee f17 -r ..r .................... Signature.of Applicant .:....�.. ..... /..... ........ . USE CONRTRIICTION ROOFING LAND 1 FAMILY 'WOOD WOOD`SHINGLE . PAVED 2 FAMILY STEEL SB. SHINGLL DIRT LOO CABIN BRICK TILE I OILED BUNGALOW CONCRETE METAL' SWAMP APARTMENT -STONE I I ! BROOK STORE FNDTNS. - I I INTERIOR ; I LAKE F.': ]STORE & APT. = STONE ROOMS ` DAMS ' STORE & OFFICE `^ _. CONCRETE APT. ROOMS I SW. POOLS OFFICE BLOCKS APT. TEN. COURTS GAS STATION BRICK ATTIC ',OPEN GARAGE PIERS t" ` FINISHED OTHER BLDOS. EXT. WALLS PORCHES BARNS BASEMENT =WOOD % . FRONT SHACKS PART BRICK % SIDH `' COTTAGES FULL - BRICK VAN. % REAR BUNGALOWS CEMENT FLOOR' LOG % ENCL. ! ELECTRIC FINISHED ''• SHINGLE I PHONE GARAGE B. IN. -- COMP. � I FURNACE FIELD STONE - Imenslon o ui ng Width Deptb Stories i2 .3 F" Q;QrC X X X X X Type foundations ... Size & use each ......... ... . Room with window area ........... .... ... ........ . Sewerage type "7 � ... ...... . Size of septic tank .'�'.�:.. . Lineal Ft. Drainage .. %f %........... Size of dry wells ......... .. . Additional informatio • ........ _..... /`V 111W •- . .. .ZA r bier -• I: ... ..... .......................... ........ .... This application must be accompanied by copy of�surnge ors mop and complete plans, specification, and all information required -:by - .Zonin Ordinance and Sanitary Code when requested by inspector. �} 1 i I, ......... .. .���` .. I . .. the applicant do hereby.certify that the above statements are true to my knowledg -and belief. Fee f17 -r ..r .................... Signature.of Applicant .:....�.. ..... /..... ........ . I PUTNAM COUN'T'Y HEALTH DEPARTKW DIVISION OF ENVIRONMENTAL HEALTH SERVICES � 225 -0310. PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OWNER'S NAME ,Sih i PHONE SITE I=TION / �l iQ�i9� R1� ��rN• l yi9 //i Al 1/ TO ray -s-a� -3 /sy MAILING ADDRESS S'fi� 1-5 A �� ' / PERSON INTERVIEWED 1V141X2 PCHD Complaint # Name & Relationship (i.e, owner tenant, etc.) DATER y! - TYPE FACILITY PROPOSED INSTALLER ,'�, /,--' PRONE 5-Ay - 3, 5 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. Proposal approved Proposal Disapproved Date Voposal 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' diem. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, reported agent of owner agree to the above conditions. SIGNATURE — TITLE e l•L�G�- DATE S �i�y �`�. JM: Waite (FAD); Yellcow M-kin SI); Fink (19pptio3nt) AW JifC,- Proposal approved Proposal Disapproved Date Voposal 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' diem. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, reported agent of owner agree to the above conditions. SIGNATURE — TITLE e l•L�G�- DATE S �i�y �`�. JM: Waite (FAD); Yellcow M-kin SI); Fink (19pptio3nt) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDIVUDAL ADDITION/REPAIR FORM SECTION A: GENERAL INFORMATION Name of Project �, ��� °`` (T)(V) Year of Construction V_TM# Size of Parcel SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. Offilly Molling ateep Slope 06entle Slope ❑Flat 2. ❑Evidence of wetland ❑Low area subject to flooding ❑Bodies of water ❑Drainage ditches ❑Rock outcrop = NO —4. LVater, courses exist ors; or adjacent-to-parcel:_ ~ ..__w _ .❑ _ .......:.. ; ly' 5. Existing individual wells within 200ft of the existing SSTS? ❑ SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) 1. Physical character of existing SSTS area. i" A. ❑Level Gentle Slope ❑Steep slope B. L7Well drained ❑Moderately well drained ❑Somewhat poorly drained ❑Poorly drained C. Area available for SSTS. (6/sol'm'ewhat rimary & Reserve) ❑Extremely limited limited ❑Adequate ft x ft D. 'INSPECTION Date _� f i Z�� Inspector. ONO evidence of failure ®Evidence of failure 'AMR of seasonal failure -----=-------------------- --=--=-------------- 7 -------------------------------- =------ :--- (Indicate North) p ✓ 2 In i_ o Lt J V y HOUSE D� (1) Indicate location of SSTS A. Size and type of septic tank gallons ®Metal OConcrete OPlastic B. Type of absorption area l— Fields ft - --2 —Pits 3 -fillies fI. (2) Indicate setbacks; °front street, backyard, and side yard dirriensions' (3) Show location of well (4) Show location of driveway (5) Note physical features (steep slopes, rock outcrops, streams /wetlands) SECTION E._. EXISTING WATER SUPPLY WS CiShared well ClIndividual. well []Drilled ❑Dug . OCasing above ground REPAIRS ONLY: Status: As Built Inspection Required: As Built Submitted: As Built Inspection Done: Inspector: (addrep) SALES INFORMATION SECTION DATE (MMbDYY) SALE PRICE TYPE VALID LAND BREAKDOWN SECTION LAND FRONT FEET DEPTH ACRES j SQUARE FEET TYPE- 0 t✓ / o o wn! w INFLU- TYP ME ENCE % i .I CARD NO. Of PROPERTY Q O I CLASS Z LAND CODES t>• Z 4 GAS & ELECTRIC } L 4 COMMERCIAL L � GC O r.°L 1 1' rr, j i"1'e J CD CY>Cp C4 cn j II PRIMARY 06 PASTURE 02 SECONDARY 07 VAOOLANO EA3100 REV 2/91. NEW YORK STATE DIVISION OF EQUALIZATION AND ASSESSMENT RESIDENTIAL, FARM AND VACANT LAND PROPERTY RECORD CARD AUDIT CONTROL CODES I 04 RESIDUAL SWIS /SBL /CD j 2$00 8 3.12�3—Z 05 TILLABLE L ACTIVITY N = NONE L = LISTED M = MEASURED ONLY 01 -04 SITE INFORMATION SECTION SHAPE (09) SITE NUMBER CNTY- PUT'lAM. TOWN. TWN— PUTNAA VALLEY SWIS TAX MAP NUMBER CO 3 fie 30J :83.12-3 -2 LK OWNER PROP CLASS HC S41.TN.PATRICK.4 210 LOCATION NQ LOCATION SCHOOL DIST 61 F L 0 R A O A N ROAD 3 7 2 8 0 3 SALE PRICE SALE DATE LOT SIZE - 6U. U U X `, 113 0. 0 1C TN• ENTRY 1= INTERIOR INSPECTION 2 = INTERIOR REFUSAL 3 = TOTAL REFUSAL 4= ESTIMATE 5 = NO ENTRY 01) N.EIGHWRHOOD CODE 5 VIEW (13) ZDNING CODE 6 SeWER 1 NONE 2 PRIVATE 1 3 COMM/ PUBLIC SOURCE 1 = OWNER 4 = OTHER 2 = RELATIVE 5 = NOAH 3- TENANT 6- ASSESSOR DATA WATER 1 NONE 2 PRIVATE f 3 COMM/ PUBLIC IFfIUTIES 1 NONE 2 GAS 3 ELECTRIC SITE DESIRABILITY 1 INFERIOR 2 TYPICAL 4 3 SUPERIOR SALES INFORMATION CODES 1 RURAL 2 SUBURBAN 3 URBAN SALE TYPE 1 = LAND ONLY 2 - BLDG. ONLY 3 = LAND & BLDG. hyIGHBORH000 RATING i BELOW AVERAGE 2 AVERAGE 3 ABOVE AVERAGE fTAD TYPE 1 NONE 2 UNIMPROVED 3 IMPROVED LA BEL CORRECTfaN AREA SWIS TAX MAP • OWNER FROP CLASS l� r lOL SCH ms LOT SIZE VALID 0 = INVALID SALE i = VALID SALE AUDIT CONTROL SECTION QUALITY CONTROL REVIEWER S f DATE I � NOTES: /-O �� J,L, ,,i/ c L S L L '_l q a cL.. v Q - C.'• i = it a / 7 REJECT CODE i" ASSISTANCE CODE e _ SIGNATURE BELOW DOES NOT MEAN CONTENTS VERIFIED, ONLY.THAT DATA WAS COLLECTED IN YOUR PRESENCE SIGNATURE J DATE COLLECTOR - DATE (MMDOYY) TIME ACTIVITY ENTRY SOURCE 00. =� r.z 3o g Gpi� 2- SALES INFORMATION SECTION DATE (MMbDYY) SALE PRICE TYPE VALID LAND BREAKDOWN SECTION LAND FRONT FEET DEPTH ACRES j SQUARE FEET TYPE- 0 t✓ / o o wn! w INFLU- TYP ME ENCE % i .I CARD NO. Of PROPERTY Q O I CLASS Z LAND CODES t>• Z 4 GAS & ELECTRIC } L 4 COMMERCIAL L � GC O r.°L 1 1' rr, j i"1'e J CD CY>Cp C4 cn II ORCHARD 12 HEAR 13 VINEYARD 14 WETLAND 15 LEASED LAND SOIL RATING LAND TYPES II PRIMARY 06 PASTURE 02 SECONDARY 07 VAOOLANO 03 UNDEVELOPED 08 WASTELAND 04 RESIDUAL 09 MUCK 05 TILLABLE 10 WATERFRONT II ORCHARD 12 HEAR 13 VINEYARD 14 WETLAND 15 LEASED LAND SOIL RATING INFLUENCE COOL P POOR (05) O1 - 10 1 TOPOGRAPHY N. NORMAL (06) O1 - 10 2 LOCATION G GOOD (07) 01 -04 3 SHAPE (09) 01 -04 4 RESTRICTED USE 01) 01- 10. 5 VIEW (13) 01 - 10 6 WETNESS 7 OTHER WATERFRONT TYPE I POND 3 LAKE 2 RIVER 4 CANAL 5 OCEAN R NAY RESIDENTIAL BUILDING SECTION IILDING STYLE I RANCH 07 MANSION 13 BUNGALOW t RAISED RANCH 08 OLD STYLE 14 OTHER I SPLIT LEVEL 09 COTTAGE 15 TOWN HOUSE 1 CAPE C00 10 ROW i COLONIAL 11 LOG CABIN 3 CONTEMPORARY 12 DUPLEX D SWIS /SBL /CD I MAP # STRUCTURE CODES I i -i -. -- — -�- - -- - - -- -- -- -- - --. -- - - -I-- — — GARAGES RGI ATT 1 STORY RG2 ATT T' /v STORY RG3 ATT 2 STORY ±. RG4 DET 1 STORY R65 OET 1'h STOR Y FIGS DET 2 STORY -- - - -- - - -z-- - -- 1- — - - - -• -- - -- -- - - -- - -- - CRY HEIGHT /0 _ -- -- — _ - _ - - -- -- " - -- -_- 1 — - - - -_ -_ - - -- -- - °- -- (TERKIR WALL MATERIAL I WOOD 05 CONCRETE 2 BRICK 06 STUCCO 3 ALUMINUM/VINYL Ol STONE 4 COMPOSITION _ _ -- -- --r-- - - - - -- - ---t- — -- - - - -- I -- —__ - -- -- ;--•' - -• ---- ��' POOLS LS 1 STEEL VINYL LS2 FIBERGLASS Ls3 PO UflED CONCRETE LS4 GUNITE LS5 . ABOVE GROUND BARNS FBI I STORY DAIRY I F82 1'h STORY DAIRY F03 2 STORY DAIRY FB4 1 STORY GEN FB5 1'h STORY GEN FB6 2 STORY GEN i• FB7 POLE FBB MORSE ; -- -V —' i - — — — - -- — - - -- - -- - - --- — f - ` �- — - - -- - -- -- EAR BUILT 9 S O UMBER OF KITCHENS UMBER OF BATHS I O T - r-- — FLL �jL -- - - —• -- — ` -� - UMBER OF BEDROOMS 'L —' - - — -- ` �� -� I - - -- -- - - - �' ` _ REPLACE - EAT TYPE 1 NO CENTRAL 2 HOT AM 3 HOT WATER /STEAM 4 ELECTRIC 22 7 - _ — -�.;- — -- - - - - -- - - — ...- -= -- -- - -- - - -- -! - -- - - - -- - -`- — - - - - -- -- -- -- - ----- -- - --- - - =- -- -- -- - UEL TYPE 1 NONE 2 GAS 3 ELECTRIC 4 OIL 5 WOOD 6 SOLAR 7 COAL MISCELLANEOUS RCI. CARPORT t GH2 GREENHOUSE TCI TENNIS COURT ' ENTRAL AIR- - BLANK = NO - I = YES --'---------------=-------------------=----- - -- - -- -- -- — ---- -._..._...- ---__.._---- --- - -- -- - -- ASEMENT TYPE m. ..1 PIER /SLAB 2 CRAWL 3 PARTIAL 4 FULL �yI I i CANOPIES CP5 ROOF ONLY CPB WITH SLAB CPT SLAB /SCREEN SHEDS FCI MACHINE FC2 ALUMINUM FC3 GALVANIZED FC4 BAKED ENAMEL - -- - -- -- — - -- - -- - -- - -- - ASEMENT GARAGE CAPACITY - — -- --- — -- - -- - -. -- — - - -- - 3- - - -- - -- - ONDRION 1 POOH 2 FAIR 3 NORMAL 4 GOOD 5 EXCELLENT 6 — - - ---� — IRADE A EXCELLENT. B GOOD C AVERAGE D ECONOMY E MINIMUM r V . - TRADE ADJUSTMENT -- — - A -- - -- -- MOBILE HOME RM5 MOBILE HOME MH1 MOBILE HOME BASEMENT '• MH2 MOBILE HOME ROOF MH6 MOBILE HOME 7X12 ROOM' MH7 MOBILE HOME 7X24 ROOM MH8 MOBILE HOME TIP -OUT RM' MH9 MOBILE HOME WOOD ADOQN ITTACHED GARAGE CAPACITY -_ w - _ ' _ \ry_ _ \ . - TRCH TYPE AREA - - -{ - RESIDENTIAL BUILDING AREA SECTION :IRST STORY AREA - p 3 PORCH TYPES BPI OPEN. RP2 COVERED RP3 SCREENED flP4 ENCLOSED RP5 UPPER OPEN I '. RPS UPPER COVERED ; RP7 UPPER:SCREENEO RP8 UPPER ENCLOSED ! - - SECOND STORY AREA l 1 ! Till i i i i l l i i i i i 4DOTTIDNAL STORY AREA s IALF STORY AREA. - IMPROVEMENT SECTION: i THREE QUARTER STORY AREA STRUC CD MC DIMENSION I DIMENSION 2 QUANTITY GR CD 'at YEAR BUILT FINISHED AREA OVER GARAGE IMPROVEMENT CODES G 3 g r FINISHED ATTIC AREA - MEASURE CODE 1 QUANTITY 3 SQUARE FEET 2 DIMENSIONS 4 DOLLARS . , FINISHED BASEMENT AREA 1 UNFINISHED HALF STORY FLOOR AREA GRADE A EXCELLENT D ECONOMY 8 GOOD E MINIMUM C.AVERAGE UNFINISHED THREE QUARTER STORY AREA UNFINISHED FULL FLOOR AREA CONDITION I POOR 4 GO@D - 2 FAIR 5 EXCELLENT 3 NORMAL!. j SQUARE FOUT OF WING AREA S3 FINISHED RECREATION ROOM AREA ti44