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04556
ALLEN BEALS, M.D., J.D.
Commissioner of Health _
ROBERT MORRIS, P.E., MPH
Director ofEnvironmental Health
July 16, 2014
DEPARTMENT
OF HEALTH
1 Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390 Fax # (845) 278 -7921
Eric Rosen
4 Split Rock Road
Putnam Valley, NY 10579
Re: . Addition — A- 102 -14
MARY(1ELLEN O{.DELL
No Increase in Number of Bedrooms
4 Split Rock Road
(T) Putnam Valley, T.M. 85.5 -1-46
Dear Mr. Rosen:
This Department has 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 July 16, 2014. The addition is approved with the
following conditions: ~"
1. The total number of bedrooms must remain at three without prior approval by this
Department.
The ^lea pf the existing, sew4ge disliesa;..systdii.L iid, its - expansion area -,must b&' -* ... _.' • _ _ -:.�w, . _. _
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 .. .
4. The approval is for the modifications only and does not validate any construction shown
as existing that has not obtained proper approvals from other agencies having
jurisdiction.
5. This approval is valid for two (2) years and expires on July 16, 2016.
Any permits or variances required under the jurisdiction of the Town of Putnam Valley are the
responsibility of the applicant.
If you have any questions, please contact me at (845) 808 -1390 ext. 43261.
Respectfully,
Gene D. Reed
Principal Engineering Aide
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ALLEN BEALS, M.D., J.D.
Commissioner of Health
ROBERT MORRIS, P.E., MPH
Director of Environmental Health
DEPARTMENT
OF HEALTH
Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390 Fax # (845) 278 -7921
July 2, 2014
Eric Rosen
4 Split Rock Road
Putnam Valley, NY 10579
Re: Addition — A- 102 -14
4 Split Rock Road
(T) Putnam Valley, TM 85.5 -1 -46
Dear Mr. Rosen:
MARYELLEN ODELL
I have received and reviewed the plans for the proposed addition at the above mentioned
residence. Based on the information submitted, the above mentioned addition cannot be
approved for the following reasons:
1. The rooms titled "billiard" and "walk -in" closet are considered potential bedrooms.
2. The legal bedroom count for the dwelling is three. The potential bedroom count of your
proposed addition is five. _
3 :`The additi'un 6f "a - otei tiWi bedr6om're uires this D6 artmetit's a roval of a revised
P � q P... , pP
septic system plan from a professional engineer.
Please revise the proposed floor plan to reflect no more than three 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.
Sincerely, .
Gene D. Reed
Principal Environmental Health Engineer
GDR:cml
cc: BI (T) Putnam Valley
ALLEN BEALS, M.D., J.D.
Commissioner of Health
ROBERT MORRIS, P:E.
t 'Director' of Environmental Health
DEPARTMENT
MARYELLEN ODELL
County Executive
OF HEALTH
Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390
Fax # (845) 278 -7921
ADDITION APPLICATION RESIDENTIAL ONLY
a �
uA
STREET S k� JoCk- '_TOWN h MM I -e TAX MAP It
0 s"
NAME _C� C. PHONE D
(� CH#
�I -y
MAILING
ADDRESS
Sol;�
DESCRIPTION OF _ L
ADDITION �i 1��5111
*NUMBER OF EXISTING BEDROOMS _� NUMBER OF PROPOSED NEW 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 submit this form and the following to Putnam County Health Dept., 1 Geneva Rd,
Brevz ter, NY !1,0509; P_ih;ne: (84.5). 0$- 139�J.
1. Certified check or money order for $100.00.
2. Sketches of existing floor plan (drawn to scale, all living area including basement, to be
shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin
HA -1)
3. . Two sets of proposed floor plans (drawn to scale — with name, street and tax map #)
* Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin
HA -1) .
4. Copy of survey showing all well and septic locations on the subject property to the best
of your knowledge. Include date of installation known. Contact this office with any
questions.
5. Copy of Certificate of Occupancy from the Town or Certification from the Building
Department with legal bedroom count of dwelling.
OFFICE USE
COMMENTS
4. PUT�� NI COUNTY
JUN 101 i
EA13 1i
ALLEN BEALS, M.D., J.D.
Commissioner of Health
ROBERT MORRIS, P.E., MPH
Director of Environmental Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390 Fax # (845) 278 -7921
Eric Rosen
4 Split Rock Road
Putnam Valley, NY 10579
Dear Mr. Rosen:
MARYELLEN ODELL
County.Executive
July 2, 2014
Re: Addition — A- 102 -14
4 Split Rock Road
(T) Putnam Valley, TM 85.5 -1 -46
I have received and reviewed the plans for the proposed addition at the above mentioned
residence. Based on the information submitted, the above mentioned addition cannot be
approved for the following reasons:
1. The rooms titled "billiard" and "walk -in" closet are considered potential bedrooms.
2. The legal bedroom count for the dwelling is three. The potential bedroom count of your
proposed addition is five.
,...:. 3, -=- hea dd :�oirvf-a•pot�erltlaFbeaivcnri reTdires�tlTis D,partment -vi proval"eaicvis�d "• •'.. -- ..'-."'.
septic system plan from a professional engineer.
Please revise the proposed floor plan to reflect no more than three 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.
Sincerely,
sex,:2_
Gene D. Reed
Principal Environmental Health Engineer
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ALLEN BEALS, M.D., J.D.
Commissioner of Health
Director of Environmental Health
MARYELLEN ODELL
County Executive
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Phone # (845) 808 -1390
Fax # (845) 278 -7921
Town Legal Bedroom Count & Proposed Addition Status
Re: L csie, (Owner's Name)
Tax Map #
Address: .S l& Eak a
Town: VA
Year Built:
According to records maintained by the Town,. the above noted dwelling,
is _//"'in compliance with Town Code.
.... Is not in com liance with Town Code.
..r
The Legal Bedroom Count is:
This information has been obtained from:
Certificate of Occupancy:
Other:
The plans for the proposed addition are considered:
Addition to existing house only
Teardown and/or re -build allowed under Town Regulations
Building Inspector
5.
Date
PERMIT #
BUILDING PERMIT APPLICATION
OWNER_ C !c, (, Go'.,,. T.M.#
MAILING ADDRESS
LOCATION OF
PROPERTY
SUBDIVISION
PHONE #
NEAREST INTERSECTION
LOT#
ZONING SIZE OF LOT (SQ.FT.) EST COST
DESCRIPTION OF CONSTRUCTION
IS THIS PROPOSED CONSTRUCTION SITE LOCATED IN A FLOODPLAIN? YES NO—Z
I, C76 L Uc_ , do hereby agree that the Building Code will be complied with
whether the same is specified or not; of any Law, rule or regulation affecting said structure. The Inspector
shall have the right to enter any premises during the daytime, at reasonable hours, in the course of his
duty.
All work shall be performed in accordance with the construction documents submitted and
accepted as part of this application, unless changes to those documents have been approved by. the
Code Enforcement Officer responsible for enforcement of the code.
I, the owner, will be responsible for any and all outstanding Town charges including town
consultant fees, associated with this permit and payable to the Town of Putnam Valley.
(INITIAL) k
Temporary sanitary facilities must be supplied until permanent sanitary facilities are operational
per Section 311 of the N.Y.S. Plumbing Code. A copy of the receipt for the portable sanitary
�fa�il ti s
-W -ft n•a'eatad edgeiiaent €roar o'wne tha+f the sanitary fac'Igtles aro a2vailab>ie fog== ttse'� -
in the existing structure during construction is being ne under this permit. (INITIAL)4,� .
DATE:
(Owni5r or Agent)
PUTNAM COUNTY CONTRACTOR'S NAME & LICENSE #
I find plot plan to conform to the Zoning Ordinances of the Town of Putnam Valley and hereby
approve same; subject to further approval and compliance with the requirements of the State Building
Code as well as any other law, rule or regulations of the State, County, Town or Bureau or Department
hereof.
DATE:
BUILDING AND ZONING INSPECTOR
PAID: Permit $
ZBA APPROVAL
Total $
Rev. 3 /9/12
"NOTE: Part 56 -5 of the NYS Code of Rules & Regulations may require an asbestos survey in
conjunction with any demolition,, renovation, remodel or alteration. Please contact the NYS Labor
Department for further information. (Tel. 518- 457- 2072).
DEPARTMENT OF HEALTH
Division of Environmental Health Services
110SOLD_ROUTE SIX CENTER,' CARMEL, N.Y. 10512 (914) 225 -0310
APPLICATION TO CONSTRUCT A WATER WELL
PCHD PERMIT #
WELL LOCATION
Street Address l
J // �Gc!%%1 a
Town Village C,eity / Tax Grid Number
�c°!�i lrtl /4� %OO 13sm+ry .
WELL OWNER
.Name Mail in
J� fj 0
Address :.1d4LI-tvate
✓! O Public
USE OF WELL
primary
2 - secondary
fii.MSIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP IT ABANDONED
® BUSINESS O FARM O TEST [OBSERVATION O.OTHER (specify
® INDUSTRIAL CIINSTITUTIONAL O STAND -BY
AMOUNT OF USE
YIELD SOUGHT gpm /#
LACE EXISTING SUPPLY
® NEW SUPPLY NEW D LLING
PEOPLE SERVED,3_./EST..OF DAILY USAGEC� gal
® TEST /OBSERVATION CIADDITIONAL SUPPLY
® DEEPEN EXISTING WELL
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
ud ,P
WELL TYPE
R LLED
®DRIVEN
®DUG GRAVEL. OTHER
IS WELL SITE SUBJECT TO FLOODING ?. YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 5C
Lot No.
WATER WELL CONTRACTOR: Name Address.:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES 4xw
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN
LOCATION SRETC SOURCES OF CONTAMINATION PROVIDED
EPARATE SHEET
(date) (s
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within
thirtg (30) days of the completion of water well construction, the applicant 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 attached to this permit.
3. Submit a Well Completion Report on a form provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or 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.
Date of Issue:
Date of Expiration 19 Permit Issuing Official
Permit is Non - Transferrable White copy: HD File Pink copy: Owner
3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
MARVIN O'DELL
Inspector
TOWN OF - PUTNAM VALLEY
BUILDING, ZONING, AND SANITARY DEPARTMENT
November 1,' 1991
TOW_ N HALL
PUTNAM -VALLEY, N,Y.
(914) 526 2377
Department of Environmental Health
110 Old Route 6
Carmel, N.Y. 10512
Re: Proposed Well(Redrill)
TM# 85.5 -1 -46
Coyne -4 Split Rock Rd.
Gentlemen:
The proposed. Water Well site as shown on the attached
drawing was inspected on 10/31/91 , and as could
be determined was. found to be a minimum of one
hundred (100') feet from any. reported sub - surface
sewage disposal area.
Applicants that receive permits shall upon completion
of construction, submit to the Town of Putnam Valley
_.
(Building Department)a.copy of the well drillers Log
_...:. .
_ and-::Wa-ter.. ;anaJ;.ys.is xeport __be -fore .said. well
in service.
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MARVIN 0 D L
Building- Inspector
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SURVEYED
FILE NO.
AS IN POSSESSION r-4;90-3
—14-
N. Y. S. LIC. N6 28694
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