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83.81 -1 -61
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OWNER'S NAME
SITE IDCATION
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PLTPNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR
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93, 91-1-41
P= Canplaint #
Name & Relationship (i.e own ,tenant, etc.)
TYPE FACILITY �b S
PROPOSED INSTALLER A kko w XC • 1 N c- . PHO0
REGISTRATION # I r*4-L.
Primal (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.
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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' 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, or reported agent of owner agree to the above conditions.
SIGNAZiJRE
TITLE - �5.��� DATE -L-ZZ -99
IPg.S: White (MD); Yellow (Mm HE); Pink Vq2 icant)
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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' 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, or reported agent of owner agree to the above conditions.
SIGNAZiJRE
TITLE - �5.��� DATE -L-ZZ -99
IPg.S: White (MD); Yellow (Mm HE); Pink Vq2 icant)
LORETTA MOLINARI
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT J. BONDI
County Executive
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
September 20, 2004
Longo
25 Bogert Ave.
White Plains, NY 10606
Re: Addition — Longo, 29 Avon Rd.
No Increase in Number of Bedrooms
(T) Putnam Valley, TM #83.8,1 -1 -61
Dear Mr. & Mrs. Longo:
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 September 17, 2004. 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
maifitdi ed. __. _ -
3. All plumbing fixtures must be updated with water saving devices, i.e., new flu
low sh "
toilets, restrictors for shower heads and faucets, etc.
Any 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.
ML: hn
cc: BI (T) Putnam Valley
Sincerely,
Michael Luke
Public Health Sanitarian
'LORETTA MOLINARI
Public Health Director
ROBERT J. BONDI
. County Executive
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 10509
Environmental Health (845)278-6130 Pax(845)278-7921
-Nursing Services (845)278-6559 WIC (845)278-6678 Fax(845)2778-6085
Early Intervention/Preschool (845)278-6014 Fax (845) 278 - 6648
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET 9 dvoAz/(I)',X_ TOWN 444,krki//TX MAP #
Aq3 -'V
NAMEE,,,,A,,j
PHONE&/ d Q
MAILING ADDRESS Al V 10KOJC
DESCRIPTION OF ADDITION' &_d,,o,.,, *-:S1Qf'c`r4e- Ck-/f-q'
NUMBER OF EXISTING BEDROOMS__L PROPOSED # OF BEDROOMS 2
(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. ofthe - Putnam County Sanitary Code-.`
Please submit this form and the following to Putnam County Health Dept., 4 Geneva Rd.-,
Brewster, NY -10509, Phone 278-6130.
l.Certified check or money order f6r $ 100.00
2. Sketches of existing floor plan'(drawn to'scale, all living area including basement)
Non-prof6ssional, 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 offiurvey 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 Ceft.,of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
Comments
Feb 98
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
Putnam County Dept. of Health
1 Geneva Road
Brewster, NY 10509
Re: LoN &
Residence
ROBERT J. BONDI
County Executive
Tax Map , 1W 1—
Town_ C"
To Whom It May Concern:
According to records maintained by the Town, the above noted dwelling,
_.......__._8.....
IS NOT /
In compliance with Town code and the total number of bedrooms on record is 1
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD: 1�
OTHER:
Building Inspector
houseguidehues
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PUTNAM COUNT�,DEPgRTMENT OF HEALTH
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HOUSE PLANS APPR6VED FOR ,
BEDROOM COUNT ONLt,
BEDROOMS
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S+gnature $ Title
Date
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09/16/2004 23:46 9142850037 ANTHONY PAGE 01
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PUnMM COUNTY REAL79 DEPAMENT,1.
DIVISION OF MaRMENTAL B�aM SMICES-.
PFOPOSAL FM MAGE DISPOSAL SYSTEM REPAIR
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VtSON INTERVIEDW—ED PCHD O faint #
Nam & Relationship (i.e, tenant, etc.
ATE TYPE FACILITY
?)POSED nwxzm A Ulo ex e- P4 C PHONE %-L-6500
LEGISTRATION # --L-
_Xqaosal (include sketch locating all adjacent Wells)
gn: Repair must be in same location and of same type as original sewage dispowl aystem.
)ifferent location may require subuttal of proposal from licensed professiaml engineer or
registered architect.
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Proposal approved with the followi!n conditions
1. of any Town permit, if applircable.
2. Sttmission of as Wilt repair Aitcb--in. dupl -iqk.. ing:
a. Owner I s name.
b. Site Street Name, M7*m and Tix -Map nuuber.
c. Location of installed ampanents tied to two fixed points (e.g.,rhouse 0011�rs).
d. Systen description (e.g., 1250 gal.' concrete septic tank, three pre= t 6' diem. x 61 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.
Tr=
09/13/2004 03:51
9142850037
LORETrA MOLINARI
Public Heath Director
ANTHONY
DEPARTMENT OF HEALTH
i Geneva Road, Brewster, Now York 10509
Environniental Ilealtb (845) 278.6130 Fax (845) 278.7921
Nursing SeAMces (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Interveutlowrreschooi (845) 278 - 6014 Fax (84S)-279 - 6648
August 23, 2004
Putnam. County Dept. of Health
1 Geneva Road
]Brewster, NY 10509
Re: 99 Avnn Rnad
Residence
PAGE 01
ROBERT 1, 13ONDI
County Executive
Tax Map 83.81 -1 -61
Town of Putnam Valley
To Whom It May Concern:
According to records maintained by the Town, the above noted dwelling,
IS NOT
In compliauce with To,,Am code and the total number of bedrooms, on record is
This information has been obtained from-
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD: xxx
OTHER
Building Inspector
lxouseg�udelmes
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
Longo
25 Bogert Ave.
White Plains, NY 10606
Dear Mr. & Mrs. Longo:
ROBERT J. BONDI
County Executive
September 10, 2004
Re: Addition — Longo, 29 Avon Rd.
(T) Putnam Valley, TM #83.81 -1 -61
I have received and reviewed the plans for the proposed addition at the above- mentioned residence.
The plans indicate that the proposed addition will consist of the following:
Adding a bedroom to a second floor.
Based on the information submitted, the above - mentioned addition cannot be approved for the
following reasons:
..__T e legalbe�}roorr eo fflr the dvveliing is one. The potential bedroom`couni of your-proposed- —
addition is two.
2. The addition of a potential bedroom requires this Department's approval of a revised septic
system plan from a professional engineer.
Please revise the proposed floor plan to reflect no more than one potential bedrooms, or have a
professional engineer or registered architect design a sub - surface sewage treatment system meeting
present code requirements.
If you have any questions, please contact me at your convenience.
ul_ K �f_
Sincerely,
Michael Luke
Public Health Sanitarian
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