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HomeMy WebLinkAbout4277DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.83 -1 -4 BOX 32 04277 BRUCE- R. Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 LORETTA MOLINARI RN., M.S.N. J 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 October 4, 2002 Roy Cagliostro 34 Oriole St. Putnam Valley, NY 10579 Re: Addition - Cagliostro, 34 Oriole St. No Increases in Number of Bedrooms (T)Putnam Valley, TM #83.83 -1 -4 Dear Mr. Cagliostro: 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 October 4 2002, 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 sewage disposal system, and its expansion area, must be constructed as shown on plans prepared by Donahue, PE and approved by this department on April 13, 1998. 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 yours, William Hedges WHJm. Senior Public Health Sanitarian CC:BI 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 October 4, 2002 Roy Cagliostro 34 Oriole St. Putnam Valley, NY 10579 Re: Addition - Cagliostro, 34 Oriole St. No Increases in Number of Bedrooms (T)Putnam Valley, TM #83.83 -1 -11 Dear Mr. Cagliostro: 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 October 4, 2002 . 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 sewage disposal system, and its expansion area, must be constructed as shown on plans prepared by Donahue, PE and approved by this departmen on April 13, 1994. 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 you ,----- William Hedges WH:Im Senior Public Health Sanitarian cc: BI A f r •• •1 x,01• • 1 ' WOMY, 00 ".-6*1. OWNER'S NAME A) �e C d LL / Or, j1t'' 6 PHONE SITE i=TION l� /bYf ;S'' %Ji' '% A.9-A/ 4,tz mil# ieJ ^ 8o MAILING ADDRESS bg /c G % S %//P % 7• $k' E /°ee.eS:E /G L PERSON nMERVIEP&D Al /,� Pa!D Caq)laint # ganfe � & Relationship U.e, owner,tenant, etc.) DATE TYPE FACILITY PROPOSED IABTALLER PSG REGISTRATION # Prcposal (include sketch locating all adjacent wells): NOM 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. ripple IG /f Aj'1 1164) Vfiiie) %e. P f= F1Y /R 44 01 /6ViV G tF A�� p��Prs�l[s ('L -CLE2 —/ He 4Jj4Z- A�� �u��� -7 i&2= Gljnl3i/z y�'� /c, A/ 6F '% 172 7 �S7J%C�"! % /f� �Li %L� f nr� /.r / g o rh'4TC �f 2. 3. anal approved with the following conditions: Procurement of any Town permit, if applicable. 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 fined points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. drywells surrounded by one foot + gravel). e. Installer's name and number. System repair to be performed in accordance with the above proposal and conditions. x 6' deep I, as-vw r rted owner agree to the above conditions. !�� SIGNMURE 2- -� TITLE DATE QPgS: tt to MV; YeUcw ('lton BI); Pink (P%Uaknt) PC -RP 97 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A .ATER _WELL -- Y »•r _ -- please print or type _ PCHD Permit # Well Location: Street Address: Town/Village Tax Grid # / z g y Map�Q, 2 lock l Lot(s) Well Owner: Name: Address: CgGuibs;wo arpiaa C S.Prr -T Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought �� gpm ea e erved Est. of Daily Usages gal. Reason for Y Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason D F v e L v iO bilrAR f uFVr ; for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ...:............................................. ............................... Yes No _J Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision Lot No. Water Well Contractor: Address: Is Public Water Supply available to site? ....................:............. ............................... Yes No Name of Public Water Supply: /v 14 Town/Village Distance to property from nearest water main: N //t Proposed well location &. sources of contamination to be provided on separate sheet/plan. c � Applicant Sig v. nature::. �.. ...:... PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED •FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. --- -_ _. Date of Issue Permit Issuing Official: Date of Expiration _2 Title: Permit is Non - Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy Owner; Orange copy - Well driller Form WP -97 DANIEL J. DONAHUE, P.E. CONSULTING ENGINEERS 120 Breckenridge Road Mahopac, N.Y. 10541 April 1, 1998 914-628 -7576 Putnam County Department of Health Geneva Road Brewster, N.Y. 10509 ATT: Wm.. Hedges RE: SETS Repair Property of Cagliostro Oriole Street Pram galley Dear Mr. Hedges: Mr. Cagliostro proposes to renovate his existing residence which is in disrepair at the above location. As part of the renovation, he plans to repair the existing septic system that serves the two bedroom residence which is the purpose-fof this application. Enclosed please find: 1. A proposal for a sewage disposal system repair 2. Design data sheet 3. V41ell permit application _._... 4. Four plans of the repair. " - - ........ Your prompt attention would be appreciated. Since , Daniel J. Donahue, P.E. Site - Sanitary - Environmental BRUCE R FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI RN., 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 (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 , ADDITION APPLICATION !RESIDENTIAL ONLY) STREET 3 N ©/'°: O �v 5 i TOWN /0 &/ ' -TX MAP#. ,f J e3 NAME PHONE P CHD# MAILING ADDRESS S she DESCRIPTION OF ADDITION je NUMBER OF EXISTING BEDROOMS 2:- 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 accordaace with app cable sections of the _ Putnam County 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. OFFICE USE Comments Feb98 BFhouseguidelines PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL _ .�-.. .:j. _ a: .; ::P�eQs& Rst'!torlype �,� . r = -� -,� -•- — --- P0413- Perm it # Well Location: Street Address: Town/Village Tax Grid # L E �t'�, % �l qo� G ° , Mapf'2, 12Block / Lot(s) Well Owner: Name: Address: i bf %iv '6� /Gi -G_` Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought rgpm U d Est. of Daily Usage a gal. Reason for Y Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason DF' 6'0 L.u%0 'U'Af Jx C4'vol'7 e 12 6tr j W i'Y z for Drilling Well Type ,Drilled Driven Gravel Other Is well site subject to flooding? ... ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No Name of subdivision Lot No. Water Well Contractor: -77R- P Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: N 14 Town/Village Distance to property from nearest water main: A1/1f Proposed well location & sources of contamination to be rovided on separate sheet/plan. r' Date: 3 3la Applicant Signature: PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to. be constructed by a water well driller certified by Putnam County. Date of Issue a-'r t! / .3 Date of Expiration F Permit is Non - Transferrable Permi Title:. White copy - HD file; Yellow copy - Building Inspector; Form WP -97 il.-14 t ii -.7 . ..... .. .... CrUXARL VL-Atj WV, LL 1. � f 1. fv LL 4§0 I 1`1 -.7 . ..... .. .... CrUXARL VL-Atj WV, LL 1. � f 1. fv -�- T.6 f- ELV, Ui T I-N-1 'S UNLC,�AIIV R�i ck 6- 1.1 0 S.-I -LZL-, 5c::-D i rl (kUAAO�4 Sbyi�'L Vc3•+ 1 � r..l?�N s C t`ti L�•. �1�IL�r .. + Y 4� a ©LZ 1 1 VL P CVAS 1(4 LL (II r 111Lkivl 11 VU111 1 L.GrLLitllrll'r1\ 1 vi ii,uraa�is� DIVISION OF ENVIRONMENTAL HEALTH SERVICES 1 DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM JC)wner 101' l;A �%aiEo = Address Located at (Street) D/F /OL F S 7`leg oT Tax Map a, Block l Lot (indicate nearest cross street) Municipality Pt_rrN4m Drainage Basin //vai GN /?/061 SOIL PERCOLATION TEST DATA Date of Pre - soaking : 4 / M Date of Percolation Test 0- /�`yP Hole No. Run No. Time Start - Stop Ela se Time Min.) Dep th to Water )From Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Nn/Inch ? 2.0 S79 2 y a 9 J,o s-6 3 //�3 �� s / a 4/ 0 - 7, S" 2, -S 4 5 Q IV 02 3 a IL 2 - � �y /I 1 . S' ily _ 4 Y 5 1 2 3 4 5 NOTES: 1: Tests -to be repeated at same depth until approximately equal percolation rates are ootamea at eacn percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 TEST PIT DATA DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLIES Indicate level at which mottling is observed fio Af r- Indicate level to which water level rises after being encountered IV" tf Deep hole observations made by: ,#Al r fL Date Design Professional Name: ��NiEL. SL �a 614 k v F Address: Signature: Design Professional's Seal �0� YSS I c� JV� c c:�r • RQLE NO.... - _ =: -HOLE NO. - ,. -.I TOLE NQ. , G.L. 0.5' yr'Syi� 1.0' 1.5' S �f 2.0' 2.5' 40.1 r' 3.0'_ 3.5' 4.0' 4.5'E 5.0' 5.5',x, Ec 6.5' ro --_ _ 8.0' 8.5' ° cn 9.0' 10.0' Indicate level at which groundwater is encountered /V o ,YE Indicate level at which mottling is observed fio Af r- Indicate level to which water level rises after being encountered IV" tf Deep hole observations made by: ,#Al r fL Date Design Professional Name: ��NiEL. SL �a 614 k v F Address: Signature: Design Professional's Seal �0� YSS I c� JV� c c:�r • PUTNAM COUNTY DEPARTMENT OF HEALTH ' DIVISION OF ENVIRONMENTAL HEALTH SERVICES IIiESIGN DATX SfiaT -% SUBSURFACE SEWAGE TREATMENT SYSTEM Owner Located at (Street) Municipality Address Tax Map Block Lot (indicate nearest cross street) Drainage Basin SOIL PERCOLATION TEST DATA Date of Pre - soaking Date of Percolation Test Hole No. Run No. Time Start - Stop Ela se Time Min.) De th to Water rom Ground Surface (Inches) Start Stop Water Level Drop In Inches Percolation Rate Min/Inch 1 2 3 4 5 1 2 3 4 ti 5 1 2 3 4 5 MUTES: 1. -Nests to be repeated at same depth until approximately equal percolation rates are ootamea at eacn percolation test hole. (i.e. s 1 min for 1 -30 min/inch, s 2 min for 31 -60 min/inch) All data to be submitted for review. 2. Depth measurements to be made from top of hole. Form DD -97 2 TEST PIT DATA - DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. HOLE NO. �— HOLE NO. G.L. 1.0' �Sr 2.5' 3.0' 3.5' 4.0' oe 4.5' 5.0' _ 5.5' 6.0' 6.5' 7.0' .tia �2G 7.5' 8.0' 8.5' 9.5' 10.0' Indicate level at which groundwater is encountered Indicate level at which mottling is observed.' Indicate level to which water level rises after being encountered Deep hole observations. made by: Date Design Professional Name: Address: Signature: Design Professional's Seal PUTNAM COUNTY D9P k . 30, WALV,- i 4 C.L. W ALV"- W (,A- l• W M&C.Tclk PA pr Sisk I Ci)Aoowl IS' v- 2.Li' (D Li ' 4. .LL,_ HOUSE PLANS OUNT ONLY; F7 BEDF(()O',lt C UID 0 -2-BEDROOMS VDi)- -R-b� b-Djou- S-T-.