HomeMy WebLinkAbout3836DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
83.12 -3 -5
BOX 30
UAW
9
a
go L :1:i.
IN
614 :1
r-
WI
WIN
�'�
i
0
-
�'
-
IN �;
,�
■
PU NAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENM HEALTH SERVICES i� V
MPOW FOR SEMM DISPOSAL SYSTEN REPAIR
OWNER'S NAME f4",&i MME 6 .ES:00 1 r a- DOWA �'��0 l3,ofXCo PHONE �;?4 - 5-Y75-
SITE LOWION .�� -F b �g y jW )?J- 24# 8 3 I a-3-57
MAILING ADMIESS ,trx 1};^ VA & LZV , rl -Y. 105-15-
DATE
I
PW Complaint #
Name & Relationship (i.e, owner,tenant, etc.)
D - - - - TYPE FACILITY 9,65
PHONE f2,6 -ate F
X
REGISTRATION # / 3q
proposal _(include skew 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.
Cn kiku�ktT v U)04-Tr-11-
Proposal approved Proposal Disapproved
Inspector's Signature & Title to
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
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 t c y-C Jr-, DATE
QP16: Wzite (PC D); Yellow 03In BI); Pink (41l.icant)
PC -RP 97
BRUCE R. FOLEY, R.S.
Acting Public Health 0:-e_;-.
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
Geneva Road, 6revrster, New York 10509.
(914) 278 -6130
Per QS =D ADDITION AP?LiCA T ICN' _ (RESIDENTIAL ONL Y
STR =T: TOtilN' TX MAP T ?3,1 2
A�Ari� �SWSI P;;O`_ .ql�• 5�� SN�}5 PCHO PERMIT
i.-
na Capobdatxo
M"'ILIN3 ADDRESS
Ilescription of -Addition
Nu�;b -ar of existing bedrooms _ Proposed number of bedrooms.
ro m Certi f icate of Occupancy or
Certification from 6uildin_= Inspector
Any addition which is considered a bedrecm. requires formal approval of plans
(Construction Permit) prepared by a Professional Engineer or Registered Architect
in accordance with ap;olicable sections of the Putnam County Sanitary Code.
Please submit this form: and the following to PUTNAM COUNTY HEALTH DEPARTMENT,
4 G= �;SVA._RO D,...6 �yS.TER., N Pinion= 278 - 6130. with the fol- lowing- .-information.
1. Certified Check for $100.00.
2. Sketch of existing floor plan (all living area including basement, if any)
Non - professional drawing is acceptable.
3. Sketch of proposed floor plan . fit" 11
Non professional drawing is acceptable
4. Copy of survey showing well and septic location, to the best of your
- knowledge. Include date of installation if known.
Include all wells and septic systems within 200 feet of property line. Any
questions please contact this office.
5. Copy of Certificate of Occupancy from Tori'n or Certification from Building
Department of legal bedroom count of dwelling.
OFFICE USE
Comments and /or conditions
application
August 1995
July 1996 (Revised)
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
February 12, 1998
Ann Marie Esposito
53 Floradan Road
Putnam Valley NY 1 -0579
Re: Addition - Esposito 53 Floradan Road
No Increase in Number of Bedrooms
(T) Putnam Valley TM# 83.12 -3 -5
Dear Ms. Esposito:
BRUCE R. FOLEY
I have received and reviewed the plans for the proposed rebuilding of home due to fire on February
8, 1998. The proposal for the rebuilding has been approved as per plans bearing the latest revision
date of February 12, 1998 and this Department's approval stamp.
Based on the information submitted, the above mentioned addition is approved with the following
conditions:
2.
3
The total number of bedrooms must remain at two without prior approval by this
Department. _
The area of the °existing sewage disposal- systerfi fhd -its expansion area, must'be _
maintained.
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.
Very truly yours,
Michael Luke
ML:tn Public Health Technician
cc: BI (T)
\v
'L
S- ;( 7
sTO
_.,.t Q
L 1
t
PUTNAIM COUNTY DEPARTMENT OF HEALh
HOUSE PLAIT", APPP.01VIED FOR
BEDI-1001.1 COUIL' ONLY;
S 10 1 '14 /1018 MR-
I
OC
, i
7�
A"
poop
CZ
it
t
PUTNAIM COUNTY DEPARTMENT OF HEALh
HOUSE PLAIT", APPP.01VIED FOR
BEDI-1001.1 COUIL' ONLY;
S 10 1 '14 /1018 MR-
I
OC
, i
7�
A"
t
PUTNAIM COUNTY DEPARTMENT OF HEALh
HOUSE PLAIT", APPP.01VIED FOR
BEDI-1001.1 COUIL' ONLY;
S 10 1 '14 /1018 MR-
I
OC
, i
cSJ�0/7 G . .
D E M O L I T I O N 98
RERMIT
Location of Premises 53 Floradan Road - TM #83.12 -3 -5
AnnMarie Esposito/Dana Capobianco having
heretofore filed an application for a demo . permit pursuant to the Zoning Ordinance, Sanitary Code,
Building Code and the Laws in effect in the To P8` Putnam Valley, Putnam County, New York, and having'
paid the required fee in the sum of IIVV CC;; it appearing from the said application that the
proposed improvement is intended to and will comply with the requirements of the law as aforementioned,
a demo permit is hereby granted this 11 day of February 1998 .
Additional information Demolish Fire Job
TOWN OF P ;
NOTE: This permit expires one year from IV`VALLEY , NE E W f'
- - -- -- -date of- issue— - -- _ -- gy - - - -- a"a°".,� -:•c, r -- - - -
.r r'.