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Home My WebLink About4005DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.64 -1 -55 BOX 31 04005 rm 0�f- 04005 OwNEI SITE MAILING ADDRESS PERSON INTERVIEWED �� c, j� y, t PCHD Complaint # Name-J& Relationship (i.e, owner tenant, etc.) DATE TYPE FACILITY PROPOSED INSTALLER PHONE 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 fram licensed professional engineer or registered architect. Proposal approved _,* mac, /U D. In ctor's Si nature & Title Proposal Disapproved IN WWI I' m) oxe,& , A-S' 6eq i r -- Date closer fo s - w i,- 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 canponents 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, or reported agent of owner agree to the above conditions. SIGNATURE � & 4 TITLE DATE M: Mite (PUD); YeUcw (Tam HI); Pink QRIiamt) DIVISION OF ENVIRONMENTAL HEALTH SERVICES o a OWNER'S NAME . IYC A C L � -U C �� 9�( PHONE S L�- Z SITE LOCATION �, 0 % I� Rio P �r �2 d TO a — MAILING ADDRESS PERSON INTERVIEWED PaM Complaint 0 Dame & Relationship (i.e, owner,tenant, etc.) DATE TYPE FACILITY PROPOSED MTMZM Q PHONE 'Z, 2-225 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 suhmittal of proposal from licensed professional engineer or registered architect. �� Proposal approved Proposal Disapproved 2,/7 c s Signature/ Title with the following conditions: to Procurement of any ltbwn pernut, it applicanieo 2e Submission of.as built repair sketch in duplicate showing: a. owner's name. b. Site Street Name, Town and Tax Map number. co Location of installed components tied to two fixed points (eog.,house corners), d. System description (e.g., 1250 gal. concrete septic tank, three precast 6® diamo x 69 deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be perform in accordance with the above prod and conditions. I, as owner,; r repo a of owner agree to the above conditions. SIGNATURE TITLE _X a j Vc-L -CA ,.• DATE / I-I'l }ES: ftte (PGD) $ YP.Ucw (Tim HO; Pink (ApUnt) �I Inquirilt >I mW be directid to fhe A/ .a c offiu. Tile No. K 497 e g 9a � 9.s• .r y4 y I rrO �dC 97 f6 As- h SURVEY OF PROPERTY PREPARED FOR OYAal1Y� dVIAQ THEWS X514W A7 E N PUTNAM, COUNTY NEW YORK SCALE 1 i' " 4q R. 19 r/ . IT IS HEREIT CERTIFIED, THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE'EXISTING�COQE;OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE' ASSOCIATION OF PROFESSIONAL LAND SURVEYORS, ' ALL' CERTIfIOATIONI -ARE, VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAPS OR OOMW BEAR THE' IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS, HEREON, 1; IUCHARRP H: GORR THE SURVEYOR•WHO MADE THIS MAP, DO HEREBY CERTIFY rMT /THE S.U,R If SHOWN HEREON W� COMPLETED ON rya 19 j/ AND TNAT,THIS 11A� WAS COMPLETED, ON I r/ox 4;p , Iv r/ ✓ 2 ! o �a 4o fo 99i�e,�aa.�rvt� B %gam. 8.sflar.�n iiii�o�, o rc oa a v en7i /ic1/ ',:a.t'r •`��e.C.Ki /,; Pkv dr/n G�oanfy C/t, s 014 cP. //gy sg 9as,'`/a o:t!_° /Bjr LIC. 40513 79ro�. iii ro daTa /'Y 7 1.foe- RICHARD H. GORR !+c4ove f oouGnirB,F/sle 74�•r�vts ! LAND SURVEYOR 0'.0 wt 4V lei /AM purl✓/- OLDSTONE BLDG, CLARK PL. COLD SPRING N Y. _ MAHOPAC, N.Y. 4 Tax Survey No. % / • 7 NOw4RC /VTTON Oe., M.A. i' � �e /dsyl nle't�j I nwv K AREA - 0.801 g AC. j .tJE' � � ,• ��o i Z ! i ' �� cJ�� p. Scrricc• I r•• J. si /J �, rr OV CAS �rr•n�•Fe r�� /fie '�¢' �✓�9° ZS'oo "E pd, oo .5' t ., .-, a '.. -,� .. - _ ... __ <� .... - -. a... _. ..,. .. - <- -_.. �..c..»..... _� •-... .. wr :. _:: •,,. ..» v_'. e.�. _. _. ... �.. e- .^e,..'..e•a�.. ,...+'F... .. ..e...o .. SURVEY OF PROPERTY PREPARED FOR OYAal1Y� dVIAQ THEWS X514W A7 E N PUTNAM, COUNTY NEW YORK SCALE 1 i' " 4q R. 19 r/ . IT IS HEREIT CERTIFIED, THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE'EXISTING�COQE;OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE' ASSOCIATION OF PROFESSIONAL LAND SURVEYORS, ' ALL' CERTIfIOATIONI -ARE, VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAPS OR OOMW BEAR THE' IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS, HEREON, 1; IUCHARRP H: GORR THE SURVEYOR•WHO MADE THIS MAP, DO HEREBY CERTIFY rMT /THE S.U,R If SHOWN HEREON W� COMPLETED ON rya 19 j/ AND TNAT,THIS 11A� WAS COMPLETED, ON I r/ox 4;p , Iv r/ ✓ 2 ! o �a 4o fo 99i�e,�aa.�rvt� B %gam. 8.sflar.�n iiii�o�, o rc oa a v en7i /ic1/ ',:a.t'r •`��e.C.Ki /,; Pkv dr/n G�oanfy C/t, s 014 cP. //gy sg 9as,'`/a o:t!_° /Bjr LIC. 40513 79ro�. iii ro daTa /'Y 7 1.foe- RICHARD H. GORR !+c4ove f oouGnirB,F/sle 74�•r�vts ! LAND SURVEYOR 0'.0 wt 4V lei /AM purl✓/- OLDSTONE BLDG, CLARK PL. COLD SPRING N Y. _ MAHOPAC, N.Y. 4 Tax Survey No. % / • 7 NOw4RC /VTTON Oe., M.A. t ;4 y...BR:;'OE R. & CLE`t Public Health Director .LORETTA MOLINARI 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 &n &'e TOWN Oct tPCHDgAd �'# NAME / 6 i �lZL�NE l7' 706- �q o o3 MAU,IN'G ADDRESS DESCRIPTION OF ADDITION NUMBER OF EXISTING BEDROOMS % PROPOSED # OF BEDROOMS (FROM CERT. OF OPCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *Any addition which is considered a.bedroom requires formal approval of plans (Construction Permit) prepared by a Prdiessional Engineer or Registered Architect in accordance with applicable sections of the Putnam: bounty Sanitary..Code. Please submit 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. OFF7CE USE Comments ! Feb98 Khotueguidelines L' `•-•J b BRVQE- R._.FO.L.FY, ,. .- o • _ - jab& Health Director „` ::`'- 'sLI�R>7iA`` MOLFINARI 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) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278-6082 Fax (84 5) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 n Re: `1 uN1 011 rAC-9— Residence Tax Map '?3. Cod- 1 -55 Town t�Lid-ntam V'ca l e t,,t Gentlemen: 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 v (3 R=133.50' / �P 4 L=127.02' I / �5 \ Edge Of Macodam \ / Set / +;l Rod Set Area = 35,321 Sg. Ft. = 0.81086 AC?VS 00� yp\ / lock 60 / Rod Set go Frame She/ °k L=34.77' Metal Shed / cr s? 1 GUY W/ ole lb p\ \\ VO / \ 7 Meta / Shed IREP a S82°21 "40 "E 17.14' 4R.DT \ SKILL SECTION F =''- t / � � gs °'cF \ R= 116.50 ' May 28" 1929 0 S r y \ ig L=45.46' ' \(� \V OO• P D e a N7577'00 "E 60.15' conc. Walk agodam 0.95 ' :RADON OR ADD /DON 7'l; THIS RON OF N. Y.S. EDUC. L.L W r v 11 I/ (r`niRES IF ANY k/nr cunuav L LORETTA MOLINARI R.N., M.S.N. 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 August 25, 2003 Michael Reichardt P.O: Box 419 Lake Peekskill, NY 10537 Re:Addition- Reichardt, 9 Union Place No Increases in Number of Bedrooms (T)Putnam Valley, TM #83.64 -1 -55 Dear Mr. Reichardt: ROBERT J. BONDI County Executive 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 August 25, 2003 The addition is approved with the following conditions: 1. 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 mamtaine, 1. 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 your William Hedges WH:lm Senior Public Health Sanitarian cc:BI