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HomeMy WebLinkAbout3848DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.12 -3 -27 BOX 30 i � i 0 191 I 1 1 L , F? . . rLr r} `� .� . Ik� ■ �� .' 'ti ` I y� f �� I ��'� �•1' ` I `: I I�' .1 '� , I IL i � i PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES YES NO Internal Use Only PERMIT # ❑ EV epair Permit issued in last 5 years ❑ of in Waters ed ❑ Repair within Boyd's Corners, W. Branch or Croton Falls Res. Delegated ❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION OWNER'S NA MAILING ADC APPLICANT `i0 6t A-.:, rA M TOWN - 4-nat-, Qaz V_ .( TM # %3AkI- 3 -D7 Name & Rellitionship (i.e., owner, tenant, contractor) DATE FACILITY TYPE 3' n le ,' PCHD COMPLAINT # PROPOSED INSTALLER �rec_i `�;, -,� XC,a a-h'n PHONE# 245-13JO -CYG 1 ADDRESS 3 RnA m P A - RIA i rk'san REGISTRATION /LICENSE # \ O -aa Proposal (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 and extent of the repair. � nif"?'►lc n.' � lx ��.�,� f'Y��c^�� �.�,a, -, `al'Y7 � r�c p'�c .c I, as owner,agree to the conditions stated on this form SIGNATURE (owner) I, the septic, installer, TITLE DATE 5 -- -7 — C-p2 xbnditions of this permit for the septic system repair A SIGNATURE TITLE^ �S; �P�IV DATE (installer) I; ,-) . o Proposal approved 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, in 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 backfill until authorization to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved is in Proposal Denied with applicable codes COPIES: PCHD; Owner; Installer PC -RP 99ML -:5:;� O� D to Yes O Date- No ❑ Rev. 2/07 Sheet of_� PUTNAM COUNTY DEPARTMENT OF HEALTIf DIVISION.OT' FNVIRONMENTAL I3:.EATLH SERVICES.,. -. FIELD ACTIVITY REPORT AT-)T-)-R-F';-,: #D O KD 1 PUTAI,ZNI VW JA-11 A) '\I. Street Town State Zip PERSON IN CHARGE _ OR TNTFRVT- FWF.TI fM�Lg,j©NI �A.,14V*Z2,Z4 liatP 5 / 2&!!2 Name and Title TYPE OF FACILITY: 4- Signature and Title RFPQRT RFC.FT /FTC RY• I acknowledge receipt of this report: SIGNATURE: 02/96 Title; MEMORY TRANSMISSION REPORT T.i�' TEL NUMBER 8452787921 NAME ENVIRONMENTAL HEALTH FILE NUMBER 935 DATE MAY -20 08:03AM TO 97360571 DOCUMENT PAGES 002 START TIME MAY -20 08:03AM END TIME MAY -20 08:04AM SENT PAGES 002 STATUS , . OK FILE NUMBER 935 * ** SUCCESSFUL TX NOT ICE * ** Pl.lTNAM GOLSNTY HEALTH DEPARTMENT pIVISIQN OF ENVIRONMENTAL HEALTi i SERVICES u0 f_Y'/ �"<epatr f'—k taauea In last s 1<o— Watershed lL�.�(!/ Glepatr within 13oyd's Camera. W_ Branch or Croton Pa115 Rcs_ Delegated � Repair within 200 tL of a watamourse or DEC - mopped wan d O Joint Revi ®w SITE LOCATION tAO c'Zcl. TOWN ,,1 � . �.- ),al tem., TM # 1 - � - �;;) OWNER'S NAME {�'- )c'3..>^: �S -toCct - C..rl1G MAILINOAD.OF=jESS two_ (110( rtSS� r rvsme a. ree�avorrynrp (I.a_, OWrler, Senen[, conrracror) GATE �- -� - Q� FACfL1TY TYPE S :r^��Ite �,ti„�,�PCHO COMPLAINT# PROPOSED INSTALLER �r+Ea� � ,��- \ =�cc� ►a -h-r»_ 1 PHCSIVE si Q...{_� -_ ���(� -� Ora- -] � ' - AOORESS .3 (� - .�..�,.,� p C3�1 y - ..ate- t- •,5.>,.� RECitSTRATION /LICENSE p \oaa _ _ n r• .+• z ;^ror >ce 31�(inz:3 afa'9� -�a s3oPm1Etsr wkertciw C i i?rtgt'i[tin hiau+ '" ."�y:opee't- y 9f`nBS,""all adlacBnt wo(IS' WltFtin 200 .. �� _� -- ~y» _� feat of repair an0 ttta IpGatiOrt of existi►tg and proposed system) NOTE: The Department may require submittal of proposal from licensed professional depencting cn the nature and extant of the repair, 1, as owner•agree to the conditions stated on this form SIONATIJRE T1TLE (��.7 Yom- DATE ( S - -7 -C-7 owna 1, the septic installer, agre CO. PI i the nditions of this permit for the septic system repair ' (tnatallertlar) P sal fto-n °+red with th�f li In0 0o dinon I _ Procurampnt of any Town Permit, if applicable. 2_ Submission of as buin repair aketch by the septic system ln-�tmller within 30 days of the repair, in duplicate showing: a_ Cownar'S name, Site Street Noma, Town and Tax Map number b. Locoticin of Installed oomponerala tied to two fared points c. System description 1250 gall_ Concrete septic tank, etc.) d. Installers' name and phone number 3. System repair to be performed in accordance with the above proposal or"S conditlons 4. Thm proposed SSTS repair is considered a bast fit design and therm is no guarantea to the duration at which the computed &STS repair will runction. o_ "c completed work to to be t2oc c itlpd until authorization to do ao has 5oan obtoined from the Oepartmont_ INTERNAL USE ONLY Proposal Approved L=T Proposal Denfed Q - l nspector's Signature 8e Ttife / irati n Data Re air proposal Is in com lienca with applicable codes Yes p� O COPIES: PChtO: Owner: Installer PC -RP 99ML. Rev. 2/07 MAY 09,2008 09:41A 000 - 000 -00000 page 1 BRUCE R FOLLY Patblta Heahb D wtar ATTI2MON: LORETI'A MOLINARI R.N, M.S.N. Anal -W Psbttr Moakh Diftdor Arartw of Pa"M Sorwe" DEPARTMENT OF BEAt,TH 1 aenava Road ,Brewstor, New York 10509 REQ T " � I EELD TEaTINQ (3 JOSEPH PARAVATI )(GZM REED Aril information below must be ! completed prior to any ftheduGng. I)ATIF- ENGINEER OR FiItM: �ta� c�•is? �r.a.3►T. PHONE #: DEEPS: )n PERCS: a PliAiaa'iM; o ROADISTREET• LAO (' )rrr D,% g-A ;4a - TOWN : «- �Y,,,,, TAXMA►P#: SUBDIVISION: Dons: y, YES NO a � a � v � a proPote 8$75witbia ate- E= :°alnar.::asin ofAv. Corarr m- rvoin. Proposed SETS within 300 feet of a reservoir, reservoir stem or control Inks. Proposed SSTS within 2* feet of a watercourse or a DEC wetiand. Proposed SSTS dear flow greater than 1000 galloadday or SPDE,S Permit required. Proposed SM for a Commercial Project. It is the responsibility Hof tae design professional to provide the above information prior to soil tea3ttq. This Depsrtment Will determine the NYCDEP project status (Joint or Delegated) based on the response. If you answered ja to any of the questions, NYCDEP must witness the soil tests. This ]Department will coordinate* a mutoally suitable time for field testing with that Design Professional and NYCDEP. If a project bars been determined to be Delegated based an the above response and tL.s.. subsequent information indicates NYCDLP is required to witness the soli tests, it will be the We responsibility of the design parofessioaW to scltdule re-witnessing of the soil testi q with NYCDEiP. FOR cotm M ONLY DATE- ` TM. a2 i ®tom ca�xrs• ith iiand 20 ell- cawaria U " Q" o w~ FOR TIR XAdams Corners ose Hill Park Cem _14 nb ARFAR I.. 74, 4. MR TER Brook � OAF au Moheg C top Mile Woodhafiic,' FOR TIR _14 nb ARFAR I.. au C top tsircM 'Jr. Woodhafiic,' 7A Bqc�d:erry-, Jose ood an( Ir malley ict rett BRUCE R. FOLEY . . Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services 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 December 23, 2002 Marie Feye 40 Orchard Rd. Putnam Valley, NY 10579 Re: Addition - Feye, 40 Orchard Rd. (T)Putnam Valley, TM #83.12 -3 -27 Dear Ms. Feye: I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans indicate that the proposed addition will consist of the following: Adding a bedroom on a second floor. cii thi =i �f&r is kln subndtte6d,ilie ab'6ve'mdntioiied addition cannot be approved for the following reasons: 1. Floor plans for the first floor (proposed) were no submitted with the application. If you have any questions, please contact me at your convenience Very truly y urs; D--'% Michael Luke Public Health Technician FAY6- lqo c rck"g-,A 0 to lorge .17ock, of NIF foul & Ced Kener S. 660 38' E. 1.01 17L• /717 el PC- /'I I Hemlock (101 (47 LO/ 5 NI F Robert 4rol-OW 60.00, . Hedge ext J 40 be ct�nd� ti vi Met. Wed w en "Il Z N.roG*38'W I UG ORCHARD o. 7'Ericr Aj Ui 0.00, J ROAD Jam' A- . .... .. House Fr ianK Lk w en "Il Z N.roG*38'W I UG ORCHARD o. 7'Ericr Aj Ui 0.00, J ROAD BRUCE R. FOLEY P �,_ Fa3ltc:-:�cu:'tTr�Iiis�ztor� .mss: .,;.:r:• :._... .. ,- ... _ L;)RI; i=I'it PvIGLI`rijARi' R t�:; M.S.N. s Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road /-I 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) STREETJD Qn, -6,A 2A TOWN p�4 #0-1 ( TX MAP# 1 r 3 c17 NAME c PHONESL-/,5--.K-Z8 -&!-l3 LPCHD# MAILING ADDRESS 1. DESCRIPTION OF ADDITION 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 "su6iriit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, 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. r. Feb98 Khouseguidelines .ti n A BRUCE R. FOLEY / LORETTA MOLINARI_ RN., M.S.N. Y Y Q :r ,.. —Associate Health Director = : ealth 'Dircr Director of Patient Services DEPARTMENT OF HEALTH I 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 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: Re:7� '0 Residen Tax Ma Town According to records maintained by the Town, the above noted dwelling IS .IS NOT in compliance with Town code and the total number of bedrooms on record is This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD. OTHER Building Inspector BFhouseguidelines \li -�s D- to /orge .rocl .ol Pv��a ire J.:4llcy , iV.Y• / en 7� © /V. E. Corr er- . J _..'. ...� :� . .a-atm �..-r. 4•. �!• .J 3� :.e�� .Ati+'n EJ` _" `'•a. NIF NIF Paul Br Cell ki ner Robert ,-�� & V/ v/or? X"orojv ^' 60.00' � o• 1 n V IT a O d � . 6mK 5.6• Ish 4 Mgt tea• sty. .. Frorne Spy. House , . - �_ Gam _.J b Ho LL W �m1 T Legend: A -1 =19' C -2 =18' C -3 =20' B -1 =16' B -2 =19' B -3 =28' V ��% O'E�Cr i•��'. COI - 1 (As 6 -,,41A- i�-ak -c)? V 4. Homeowner: Marie Feye 40 Orchard Road Putnam Valley, NY 10579 Town of Putnam Valley Tax Map Number: 83.12 -3 -27 Description of Repair to System: Installation of 56' of Infiltrators With 1 %2" Washed Gravel Installer: Philip Leonforte (License # 1022) Precision Excavating Inc. 3 Rochambeau Road Garrison, NY 10524 (845) 736 -0571 Installation Completed: 05 -21 -08 Legend: A -1 =19' B -1 =16' C -2= 18' B -2= 19' C -3 =20' B- 3 =28_' :�. Y'.f e bray- z0-zo08 08:03AM FROM - ENVIRONMENTAL HEALTH 8452TOT921 T -585 P.001 /002 F -935 DIVISION OF ENVIRONMENTAL HEALTH SERVICES C.) PROPOSAL FOR SEW GE TR T NT Y TEN YES NQ - Internal Use Only :_ PERMLtT 6 � !�;�::..: f��: I ❑ SITE LOCATION OWNER'S NAME MAILING ADDRESS fiopairT=t9Wit Issued in last 5 years Repair within Boyd's Comers, w_ Branch or Croton Falls Res. within 200 ft. of a waten:aurse or wetland L,JAot in Water, Delegated ❑ Joint Review yo _Q1c �a TOWN - M ar." e— F04-- — PINE # tlLiCF I APPLICANT ng! � �e_ �? � nL :2�,oc - t Name & Rellitionihip p.e_, owner, tenant, contractor) DATE -- '7 C»S FACILITY TYPE S ;r• (e ,-, A PCHD COMPLAINT # PROPOSED INSTALLER t��.; „�h XC�.ta{i r» _ PHOffE # ,RyS -7 3(,L = bt -1 I ADDRESS ^r(sor, REGISTRATION /LICENSE # k O'o")oZ07Q Progosai (include a separate sketch IocoHng the house, property tines, all adjacent wells within 2p0 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 and extent of the repair. 1, as owner,agree to the conditions stated on this form SIGNATURE (owner) I, the septic installer TITLE (7L,> r DATE 5 — `7 --C:7 of this permit for the septic system repair SIGNATURE ,�'��� Jam, TITLE Frms: Ae I A-- DATE C-) a (installer) Proposal sppMved with the foiiovApg conditions, �- Prracurement of any Toivm-f- so.:tit. it 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 tame, Site Street Name, Town and Tax Map number b. Location of installed components tied to two fared 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. S. No completed work is to be backfill until authort moon to do so has been obtained from the Department. INTERNAL USE ONLY Proposal Approved Proposal Denied 0 - ,4&a2 && =A" -5 Inspector's Signature & Title D to f Exoirati6n Date Repair proposal is in compliance with applicable codes Yes ! No 0 COPIES: PCHD; Owner: Installer PC -RP 99ML Rev. 2/07 MAY 20,2008 02:50A 8452787921 page 1 � O � O , Z n . a i t n: T � o , a ' o NIF Aoron m Aspholt 1N.23 °22't Conc. w C S?' & Iclo. Drucker Ori ve Curb ioo 0 n � 0 Q co O Conc. Woik R (n nn3 D N `V a __.. ....... .��.._. .. 30.0' rAr o 30.1' N �o 3 � 0 m n C ;o : �Z: O < S N_ > _ OQm' Z 0 Z< 61 0--40 .- =O .. c m O A.Z m M O v �Oj X n >c ✓° Drive. ° I Hemlock. Hedge °2Z'W, I oo.do, 523 °Z2`W.' 240:00' 05.23 o t/F Pad/ HQr=rne/ ;J o o oo _ 6 Z �t fj) III C CZm�f:' rtl