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Home My WebLink About4232DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.81 -2 -19 BOX 32 04232 is i l' `e NO Or ,�. . #F ' r .91-- - L 04232 BRUCE R. FOLEY Acting 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 14, 1997 Re: Addition — Bormes 196 Lake Dr. Mr. & Mrs. Bormes No increase in number of bedrooms 196 Lake Dr. (T) Putnam Valley Tax # 83.81-2-19 Lake Peekskill, N.Y. 10537 Dear Mr. & Mrs. Bormes: I have received and reviewed the plans for the proposed attition to the above mentioned residence. The proposal for the addition has been approved as per plans bearing the latest revision date of November 14, 1997 and this Department's approval stamp. Based on the information submitted, the above mentioned addition is approved with the following conditions: 1. The total number of bedrooms must remain at Two without prior approval by this Department. the ekfs-tifig-s-ewage -disposal system; a1id-its'-0_xp6nsion 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. Very truly yours .......... . .......... William Hedges Sr. Public Health Sanitarian WH/kg cc:BI (Putnam Valley) addition BRUCE R. FOLEY, R.S. Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (9 14) 278 -6130 PROPOSED ADDITION APPLICATION _ (RESIDENTIAL ONLY STREET:-/ 76 A ty 0 TOWN —P TX MAP # • �' m NAME: &,- e a "a w "I'?y ® BONNE PCHD PERMIT # Pe 7C7 51" MAILING ADDRESS `� ®�' �a #d d" " B ® Its Description of Addition E-NM Number of existing bedrooms from Certificate of Occupancy or Certification from Building Inspector Proposed number of bedrooms. 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 submit this form and the following to PUTNAM COUNTY HEALTH DEPARTMENT, 4' GENEVA ROAD, BREWSTER, NY 10509, Phone 278 -6130 with the following information. - 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. 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 Town or Certification from Building Department of legal bedroom count of dwelling. OFFICE USE Comments and /or conditions application August 1995 July 1996 (Revised) 11/13/97 THU 16:55 FAX 203 655 5027 KEANE.INC. CTXHV 0 001 1 Fax Co mmunica ®n _ ... �- � -� � r . �� - .�.' _ _ _ .._�, -- ••- 6... =. _ . a e .. .- :. a .. ,... .aw.:�..e M. To: Company: Keane, Inc. Solutions_ - IS Planning & Assessment • Project Management •: Client-Semer Development - Technology Migration • Year 2000 Compliance • Application Outsourcing • Help Desk Outsourcing KE%NE Celebrating 30 years of service to our clients Fax From: e(- 9 5 Date: Number of pages (including cover page): Keane, Inc. ` 21 Old Main Street, Suite 106 Fishkill, New York 12524 Telephone: (914) 896 -7074 Fax: (914) 896-0891 KU aZZeO'dldd S:st' _a SSflO.. low! $u'I��i 1:u �Ttid�Q i ^i-r!•IWI?d ®Q� %°°r° -�� i; .. _..... - -- I. its I JI ZOOj ;ATCL� '�tiI'S�FA}I LZOS 999 COZ.T'3 oS 41T 7 it l!�3tl yfi , +f �r 'i R� '0 sY 0 Lor GB ; w.A,.V Of Z.r RI I? i �rorasu�(]!ailM.s.► ton of O s 1 � Al/sei Ge�Ar+en r{ 4 t { . I H40 P.9SA V at oc.c IS r, Car 3 4!• 70' pu i iAt;aV1OA .. OF , �s•v Q � ALBERT" ic ROSE pAzrokE .e.atr N.r ro Stgi •'"•OV•• �! Ouwn n J SL w.a, .JvsY �Or 8I L .avism TOWN of P!/rA/AM VALLEY PurW,at! C o[/N7-Y, N. Y. w ►i e i eF PJUPAZJ 8Y: .)CNN S. R &Wtq At S L3 •A�+ ew ; —� � M , Peit.ali4 ..v1L I 4' 1 �.•�,IL Ed�q� /. i f.SOP&A ry eA LONi /AN6 to ALBERT" ic ROSE pAzrokE .e.atr N.r ro Stgi •'"•OV•• �! Ouwn n J SL w.a, .JvsY �Or 8I .avism TOWN of P!/rA/AM VALLEY PurW,at! C o[/N7-Y, N. Y. w ►i e i eF PJUPAZJ 8Y: .)CNN S. R &Wtq At S L3 •A�+ ew ; —� / NOArNei064F " Peit.ali4 ..v1L I Ir i %I c .q. ic t 11/13/97 THU 16:59 FAX 203 bi 655 5027 KEANE.INC. CTXHV q ...C, . a. s� :t % 4- T64r. PFUHAftfftv t"Wl-A W%KkeOV-4 majb4cs Lcrr co.Cot-ro. eA_6r_K 1- AS t;."awm [564%% I-Ab& mo:llbr*-A C31r- &,sVA it -•r -. cociLfry CHamPte:O TO: MA"01PAC_ UNVIO L&wvev*6 .. mr JL.WE a tam herwat. V46d In Beat. suaygyrio: 9 cf� A O."n for 1hia frousedium 'ficalian SURVtY OF PROPERTY FOR ROUG04T TO PATE m act #Oftforow to %A, riflo ce, at Clatters :ROUGHT ALD� To DA *an 6inpis aris %,oW far this f6ml if Capin Duly sad fwp 0 JOHN SAINATORE ROMEO, p1*66f PP;mpf*$wd seal of4a tug. SIT IT r I AT9 IN THE ti lmkj Ckl I NdRTHRIDGE ROAD- PUT,kri I VAU W."), COUNT PEEKSKILL. N. jl'�' 11:47prapamd 1P accaldertle ah 00 w"fing Carlo al Peavi" I- GAJ Swoop adapfW :hytho Hour Tool; 619#9 Assuiatioadho. • NEW YORK ,Lath heowd LaM Sw"Vom" POVS N V . 'i ... mw SCAM I. ei11 �• ullum tl flucy. l; S. Ac{uiq Nubh( 11413101 ()lr Pttnr DEPARTMENT OF MEALl1-1 oivislol, Of 111virolullcoul Health ScrvkCS +i Geneva Road, [Zrcwsty, Ncw York 10509 Futn azaa cowtly ucpt, ormcalll, 41 Gcncva Road 13rowsic0Y 1050' - Rt. i l ar "51y TiC$ittC17G J 1(3 {Rat1++, Tax M,41) Gct�ticl,acn: - ; Ac t•+Or6ng to records maintained 51+ dic Town, !ho abovt+ noted dwWling �+ 1S jS ,NOT in Coln ]lilallca NYWI'1 OXVI, codu anti tlu: kolal l,umbd ofbodrooms on recorc is 'fills i4ormation has bcen Oblai(led f'i0m. CCR11FICA'i'L " "• OF OCCUi'AMY: ASS13SSORS RECORD: OTHE. R /Ab Building Inspector PUTNAM COUNTY HEALTH DEPARROM DIVISION OF ENVIRONME NrAL HEALTH SERVICES 225-0310 'PROPOSAL F• a .r a O 3:: EP e, opaqm ° S NAME (Ua a d` Q rya c°L f 4 c `rt-q �, r" iv ° PHONE 4,— SITE LOCATION f 44x4 AL (v r FAILING ADDRESS (;4KQ). .1-44%�C PS'kc d _ � - 14'r37 PERSON INTERVIEWED PCHD Complaint # Name & Relationship (i.e, owner,tenant, etc.) DATE kv TYPE FACILITY PROPOSED INSST &e*-G c4L T PHONE . _5-2,6 ° n7 5` U- Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of sane type as original sewage disposal system. Different location may require submittal of proposal fr®n licensed professional engineer or registered architect. Proposal approved is 1-k-XIVIc- uo tore & Proposal Disapproved Date toposal NM owed with the following conditions: to Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. owner's name. b. Site Street Nam, 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 61 diam. 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, r reported agent of owner agree to the above conditions® c- SIGNATURE TITLE .%L (kC r La, DATE ✓ L Z MW: trite (POST); YeUcw (Tan HE); Pink (Applicant)