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631- 589 -8100
91.24 -1 -16
BOX 35
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PUTNAM COUNTY HEALTH DEPARTMENT O
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
f�
'ES NO Internal Use Only
❑ Repair Permit issued in last 5 years
❑ Repair within Boyd's Corners, W. Branch or Croton Falls Res.
❑ �� Repair within 200 ft. of a watercourse or DEC - mapped wetland
PERMIT #
'
❑� of in Watershed
[ Delegated
❑ 'Joint Review
"SITE LOCATION Z�r � l4vr3.7- TOWN l �,v �e TM # Sd� 2 y —Lll'j
OWNER'S--NAME ley✓414iL PHONE #
MAILING ADDRESS
APPLICANT -Z.._C .
Name & Relationship (i.e., owner, tenank!Lt actor
DATE , 12- v FACILITY TYPE s'/, S PCHD COMPLAINT # /f�v
PROPOSED INSTALLER , ,�Qy�cJ z }oe PHONE #
ADDRESS �� /�¢/r,� c� ��rallTc�? ,Gyp �zS3j REGISTRATION /LICENSE # U/
Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200
feet of repair and the location of existing and proposed system)
NOTE: The Department may require submittal of proposal from licensed professional depending on the
nature and extent of the repair.
.4'ev I v -X .t a4,W/ 5 eZ6tek v 3 e_"
1, as.owner,agree to the conditions stated on this form
I
SIGNATU /' 1, TITLE ,a ��.e DATE
owner) .
.� , tl :- sit'rr,•installer.,,agree•to compl;witri = -ihE drnc�it;ors-of- this:perrntt for the•saptic- system repair �•-- --�
SIGNAT-URE � TITLE DATE J12 6
.9
installer)
Proposal approved with the following conditions;
1. Procurement of any Town Permit, if applicable.
2.. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing:
a. Owner's name, Site Street Name, Town and Tax Map number
b. Location of installed components tied to two fixed points
c. System description (e.g., 1250 gal. Concrete septic tank, etc.)
d. Installers' name and phone.number
3. System repair to be performed in accordance with the above proposal and. conditions
4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the
completed SSTS repair will function.
5. No completed work is to be backfille `ntil authorization to do so has been obtained from the Department.
INTERNAL USE ONLY
Proposal Approved Proposal Denied ❑
ignature 8�Tffie Dzl e t Ex iration Date
sal is in compliance with applicable codes Yes Ear / No ❑
COPIES: PCHD; Owner; Installer
PC -RP 99ML' Rev. 2/07
.,1
NORTH ORIENTATION IS BASED ON DATUM. ESTABLISHED d .IWALIVUr . ROAD
FROM FILED MAP OR DEED OF RECORD � � --
L793!0 Q° a �+
BEING LIBER 1605 PAGE 32, FILED WITH OFFICE OF '
TE PUTNAN COUNTY CLERK'
TAXLOTAMk31G47laV
S 4 K 1 LOTS 16 6 17 AS SHOWN ON THE
SECTION PU BLOC
/V1
TOWN OF PUTNAM VALLEY TAX MAPS. '"'�� "•����..
C�91B4i4LAL7PAK)7E3F .::::::•:...:''::::t .. ..................•..;, .... :>:•::'::.:::• : :::.::..:'. :...:'.:'..:.......
1. THIS SURVEY IS SUBJECT TO ANY RECORDED AND /OR UN- GRAVEL PARKING AREA •B�,
RECORDED COVENANTS, RESTRICTIONS, EASEMENTS, RIGHT- 80.04' 1' LPIPE
D
OF -VAYS, A AGREEMENTS, IF ANY. FOUND I STONE __E�pINING g '
2. UNLESS ILLUSTRATED AND NOTED BY A POINT OF REFERENCE, j' ON LINE';
UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS, IF ANY, 1/2" TROD
ARE NO ; T SHOWN HEREOK FOUND
3. ALL BUILDING AND IMPROVEMENT OFFSETS SHOWN ARE AT ON LINE
RIGHT ANGLES TO PROPERTY LINES. I!
4. ALL EDGES AND GROUND COVER ON THE SITE MAY DT BE
SHOWN ON THIS SURVEY. , ... I .mss �' -`�) / V.
\�C( i
'L� PEEKSK�ILL, SECTION D' FILED IN THE PUTNAM? LOTJ 11 Hirt/ 1% Z /�'
COUNTY CLERKS OFFICE ON MAY 28, 1929 AS MAP 6 O .jhA PA' OFLO18 PORCH
NUMBER 185 -C, . ?7 IT1ES
LANDS NOW OR FORMERLY ! LOCK I
COTTAELL i' MAP N0. 185—C r4
1' LPIPu
LIBER 1689 PAGE 486 \ 1/24 LROD I Q'NE `4T tY� o°my s0 asMEF' LN i
FOtMD OF LDP
I L INE I I -
LAW - 'Xi?WYIMAZEP1A9'AAW )c�I LANDS NO!jZRR FORMERLY
�s17 GUE
SCHM /D and IWAXAM e I r LIBER 155 PAGE 309
�r�Lf7O1�,C��A��rW�//h��,�n�ErnwNoFPrnxatil�ALCEY �'A fTEA= 03,70 ACRES � � � aV,
P�&/�7�7� �,A7 aiOy� / pN/�EW Y 1 i I BRICK CONCRETE 4a: = c-xs TRA
A7 ALE. r' -LV' vtLJv.R "7 (frte� A , y PATIO PATIO DfbP Ql
LROD I Ti"7/� LOT
"I 4fli All ' =
((�J FGI:ND
SCALE IN FEET ONILiNE 17 I ij
END FENCE c = lliST (•jUj�
22' SOUTH
ro ¢ I I OF LINE .
°o XS Qi1�
s rAX LOT IU •,`t/
cA9?7J9r a nape e
I, ANTHONY A. SORACE, PL.S., DO HEREBY CERTIFY IN MY
PROFESSIONAL OPINION, ONLY TO PARTIES LISTED BELOV 80.42'
THAT THIS SURVEY IS THE RESULT OF AN ACTUAL FIELD
SURVEY COMPLETED ON MARCH 29, 2007 AND COMPLIES
WITH EXISTING CODE OF PRACTICE FOR LAD SURVEYS
ADOPTED BY THE NEW YORK STATE ASSOCIATION OF LAD
SURVEYORS. THIS CERTIFICATION DOESN'T RUN WITH TITLE •� . b1 sue+ '�1'
TO NOT
INDIVIDUALS, NDINGNSTIIDTHEIR SUCCESSORS
l;
AND /OR ASSIGNS, OR SUBSEQUENT OVNERSI LANDS NOW OR FORMERLY
•BOBAN OCKM ME/S'TL�fl FiiAME �o';
�� MOfiIVAQE .0ER 670 PAGE 425 , � LANDS NOW OR FORMERLY I;
i
• WAGidVIA 110RR]AGE
HIGGINS I c
LIBER 1391 PAGE 194
LICENCE ro USE StMEY;
THIS SURVEY WAS PERFORMED EXCLUSIVELY FOR THE I.
ABOVE MENTIONED PARTIES. THIS SURVEY IS LICENSED ` f �WO49
FOR I SINGLE USE ONLY AND LICENSED MATERIAL i )UORACE, w NY A.
REMAINS THE PROPERTY OF THE SURVEYOR. USE, rfpl�w `11t�L� 1 FT ��/ �1U rOv COPYING OR DISTRIBUTION WITFO UT THE EXPRESSED S'ORVE' IS VOID '.1 1 Hou 1 m I T� "LtMER s W slWI " r CONSENT OF TE SURVEYOR IS PROHIBITED - IiaasAAmm cw me wpm WT IR � P L3.
SURI�EYNo. 0289 —UPDA TF
RAISED IMPRESSION SEAL �T I 0a � T� � �^� ^� � T� mot_ MaRVEYOI
AN A A E, PLS. LIC. No. SO187 iTRVET �Aw® vlrx "" Wmui t«m w� v ❑ is vmpT� tf SfRm1 Tzos
nxvETOts R,vsD nm¢S¢o SEAL sx u st _Ur I tN 2, IF THE IEV Y= STATE ROCK TA , NEW 17473
! RE fl➢6@ERED TO 2E VALID TRUE CWD7. ENGTDN LAW. Q YOP/ 2T AMMNT Ar SOVEG PLS
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SUBJECT RESIDENTIAL SITE INQUIRY DATE : 05/07/2008
372800 PUTNAM VALLEY 91.24 -1 -16 ROLL SEC TAXABLE
PARCEL PRCLS 210 1 FAMILY RES
dCHMID SUSAN LYNNE TOTAL RES SITES 1 LAND $25,000
158 WALNUT RD TOTAL COM SITES 0 TOTAL $283,000
RES SITE R01 = _____ == RESIDENCE
�T:�; 0!8W2?�r� �xZ�a ..A BULT;�T�
PRICE $184,500 1 EXTWALL MAT CONCRETE STORIES
GRADE AVERAGE — — —AREAS
PROPERTY CLASS 1 FAMILY RES I HEAT TYPE HOT WTR- /STM 1ST STORY:
44 _
1.0
1242
ZONING
RS I
NO.
OF FIREPLACES
1 2ND
STORY:
SEWER
PRIVATE I
NO.
OF BATHROOMS
1. 0-,, 1/2
STORY:
WATER
PRIVATE I
NO.
OF BEDROOMS
3/4
STORY:
UTILITIES
ELECTRIC I
ATT.
GAR. CAPACITY
FIN
BASMT.
NEIGHBORHOOD
. 28160 1
BAS.
GAR. CAPACITY
TOTAL SFLA: 1242
== =TOTAL IMPROVEMENT
ITEMS 0 ==== I====
=____=
TOTAL LAND
.ITEMS 1
TYPE SIZE1
SIZE2 QUANI
TYPE
FRNT
DPTH ACRES SQR FT
1
1 PRIME SITE 63
1
.17
F1 =MORE ITEMS I F6 =ASMNT INQUIRY F10 =G0 TO MENU
75.20 03 -050 F4 =NEXT RES SITE ON FILE. F9 =G0 TO XREF Fll =PREY ITEMS
SHERLITA AMLER, MD, MS, FAAP
_,Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
ROBERT J. BONDI
County, Erecuttve
ROBERT MORRIS, PE
Director of Environmental Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
REQUEST FOR FIELD TESTING
All information below must be fully completed prior to any scheduling. DATE: &/z
ENGINEER OR FIRM:A,&0,yG:/ PHONE #:
PERSON TO CONTACT-'
❑ NEW CONSTRUCTION REPAIR PROGRAM ❑ ADDITION PROGRAM
REASON: DEEPS:, PERCS:'�L PUMP TEST: ❑
ROAD /STREET:
TOWN: TAX MAP #:
SUBDIVISION: LOT #:
OWNER:y�
NYCDEP CRITERIA FOR JOINT REVIEW AND WITNESSING OF SOIL TESTING
YES NO
opse.STS vjtlip_the Ilydanage basin :.ofkWet�.ran,ch:o.:ds.C.Qrs::, _. _ _. -:': ..�.
Croton Falls Reservoirs.
❑ Proposed SSTS within 500 feet of a reservoir, reservoir stem or control lake.
Q i Proposed SSTS within 200 feet of a watercourse or a DEC wetland.
❑ Proposed SSTS design flow greater than 1000 gallons /day or SPDES Permit required.
❑ Proposed SSTS for a Commercial Project.
It is the responsibility of the design professional to provide the above information prior to soil testing. The
Department will determine the NYCDEP project status (Joint or Delegated) based on the response. If you
answered Zes to any of the questions, NYCDEP must witness the soil tests. This Department will coordinate a
mutually suitable time for field testing with the Design Professional and NYCDEP.
If a project has been determined to be Delegated based on the above response and then subsequent
information indicates NYCDEP is required to witness the soil tests, it will be the sole responsibility of the
design professional to schedule re- witnessing of the soil testing with NYCDEP.
OR COUNTY USE ONLY
DATE: TIME:
COMMENTS:
REQ. FOR FIL•LD TESTING:I:LY Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
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PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEATLH SERVICES
. - .. . . . _• . �;- 7Y� IELD' ACTIVI'T'Y `RE�'CYRT' - =:� ; :�; .... r. ... , • x �, . •.;;;�..�� „;:.�: �... , .
N rte, AiAVAAJ Tal:
eT)T)T2Tagq• /6$ &/ALn/!/T Py7 -J.4A iMicrY A��.
Street Town State Zip
PERSON IN CHARGE
OR TNTFR VIEWET • 7%.✓I �/¢TLfLc74J �G��
Name and Title
TYPE OF FACILITY: l��ii(7Z
FINDINGS:
,D
Na w�e►15
I,
Signature and Title
RFPnRT RFCFTVFT) BY: -
I acknowledge receipt of this report: SIGNATURE:
02/96
Title:
SHERLITA AMLER, MD, M,S, FAAP
Commissioner of Health
�- I,��f;�l;
Associate Commissioner of Health
Mark Maxam
Susan Schmid
158 Walnut Road
Lake Peekskill, NY 10537
Mr. Maxam and Ms. Schmid:
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New Y r %5692007
Re:
ROBERT .D. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
Addition Approval- A- 041 -07
No Increase in Number of Bedrooms
158 Walnut Road
(T) Putnam Valley, T.M. # 91.24 -1 -16 & 17
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 March 6, 2007. The addition is approved with the following
conditions:
1. The total number of bedrooms must remain at three without prior approval by this
Department.
2. The area of the existing sewage disposal system and its expansion 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.
pppv'i-isfor'the prop�°sed= change3 oid this= approval do :o: gal dat ary -
construction shown as existing that has not obtained proper approvals
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 (845) 278 -6130, ext. 2261.
Sincerely,
Gene D. Reed
Senior Engineering Aide
GDR:kly
cc: B I, (T) Putnam Valley
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early InterventioniPreschool (845) 278 -6014 Fax (845) 278 -6648
a
a.
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LURETTA MOLINARI, RN, MSN
Associate Commissioner of Health
ROBERT J. BONDI
County Executive
— r:a .. ..;;;; .',i.w,;e.. ,,r,:. .:. ar �Ta. :y.+►qh ..eL'..; �'- .:•ar.: _, ._�.
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ADDITION APPLICATION RESIDENTIAL ONLY
STREET �(/%�L11%Gt �l� . TOWN I`ctW4yF7 �� ,1_TAX MAP# el;
NAME /�% / PH0NE� �'� f yS t-/2- PCHD#
MAILING
ADDRESS / 15 6'
DESCRIPTION OF
ADDITION kdc , a f/AWr, fn U1hg be i�r�iS
fir?7
l�lc/d o1 -GecY
NUMBER OF EXISTING BEI�kOOMS 3 PROPOSED # OF BEDROOMS 3
(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
s ConHealth Dept., 1 Genevand, u r Bre wsr:NY.10549�'hode -(84te v.
- ..,,... ..� ...... �......y. e� .v,
Certified check or money order for $100.00.
Sketches of existing floor plan (drawn to scale, all living area including basement)
✓3. Two sets of proposed floor plan drawn to scale - with name street and tax ma # t✓'
P p p ( p )
/4 *Non - professional sketches are acceptable
Copy of survey showing well and septic locations to the best of your knowledge.
Include date of installation if known. Label all wells and septic systems within 200 feet
of the property line: Contact this office with any questions.
15. -Copy of Certificate of Occupancy from Town or Certification from Building
Dept. with legal bedroom count of dwelling.
• f'v Wince � f Cilrrrn f Size � Se�✓e S�s�.rt . / .
OFFICE USE
COMMENTS
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
o� -
SHERLITA AMLER, MD, MS, IFAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
. a .::F -_ ..._.A`.`.$r r.; s%+'�gNiseva -�"•!4 �{`• ...3 », s�`�s1:;:v.K. ivy � =o-�, tip.'
ROBERT J. BONDI
County Executive
DEPARTMENT OF HEALTH
i Geneva Road, Brewster, New York 10509
Town Legal Bedroom Count
Re: SCHMID /LANDES (Owner's Name)
Tax Map #: 91.24-1-16
Address: 158 Walnut Road, Lake Peekskill, NY
Town: Pl]tram yal ll p-)
Year Built: 1944
According to records maintained by the Town, the above noted dwelling,
is xx in compliance with Town Code.
...... yo ....p.. y .. .�5. (,3 , t. .. -.... ..::.......- .. 1 n - c �.o�
... `.y ....p.. - .- .. -.;,.. �,..q..... _.... o,.: -� �.,, } .�.- . w• .. .. Ha .. . � pia ce M z yr o Wn o q
The Legal Bedroom Count is: 3
This information has been obtained from:
Ceitificate of Occupancy:
Other: AcePGCAr'
Assist. Building Inspector
BEN
nspection)
1/5/07
Date
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Nursing Services(845)278 -6558 Fax (845) 278 -6026. WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -664R
v
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INSPECTION
REPORT
Joe Salvati
Integrity Home Inspection Co.
Full House Inspection
Certified Termite Inspections Radon
30 Years Experience Septic Dye Test
`r(fq 410 -- 010 Water Testing
P.O. Box 254
(845) 528-7227 Jefferson Valley, NY 10535
% 5) IPL UMBflVG SYSTEM
VISIBLE CONDITIONS
5.4 The inspeyior_shallo �/ p •pip y _
r W r.... J.- .'Oi.- . • -a. %•Ow. NNVit+tiyy�•fr.�.. +. '.. �1.. - - �. .. -. - ' JUPPI bs,
L the. interior Beater supply and distribution waste pipes - Satisfactory
systems including all futures and faucet
2 the drain, waste and vent systems including
all fWares.
3 the water heating equipment
4. the vent systems, flues, and chimneyx
S the fuel storage and fuel distribution system
6. the draining sumps, sump pumps, and
related piping
I. describe.
L the water supply drain, waste and vent
piping materials
2 the water heating equipment including the
pressure - Satisfactory
vents -
sump pump /discharge
drainage - Satisfactory
fuel supply /pipe - Satisfactory
flue pipe - Satisfactory
chimney connect - Marginal
casing - marginal
tank bottom - Satisfactory
temp control - Satisfactory
relief valve? Y—es no
energy source-
the location of main water and main fuel
shut -off valve& cross connection? yes no
5.2 the inspector is NOT required to inspect.
1. the clothes washing machine connections°
2 the interiors of flues or chimneys which are leaks? yes no
not readily accessible .
3. wells, well pumps, or water storage related
equipment _
4 water conditioning system.
5 solar water heating system
6. f are and lawn sprinkler systems
7 private waste disposal systems
operate>safe�,,- 0alves or shut4fff malves.:
COADIENT'S. The house has a well and septic system T pu ps a Y h-p. Gould
about 2 years old. 7MMOANDs 1,000 gallon Neoprisma, S years olds It has been cleaned
within a year. The wellhead is buried in the upper section of the property about 7 -8' from the
oak trey It is not visible. - vJ015�i:11!1i111!alge,ortheait
YR » ct�eF�t ira tJ as iron; r A st��e ^the
bpi- o's+:. 7'�ettt%e�l °slinille. oiectedfa''irieet todaay's cod, herdomes is
la c es. 1�� a atte i�rriz d 77a 1Mk-swe li�eeaor� the:k Jaen ankE
dshagdd lie:c ®aected W
visible supply pipes. copper galvanized plastic lead
visible waste pipes. copper falvanized l� lead cast iron .
water heater. gas /lp electric oil
Make. Goidd Approximate age. Capacity.
Fe-u-737-3700 FAX= 914737.7918
CORTLANDT TANK SERVICE LLC
PO BOX 351
MONTROSE, NY 10548
BILLING ADDRESS
SUSAN SCHMID
158 WALNUT ROAD
LAKE PEEKSKILL, NY 10537
Phone: 845- 526 -1820
INVP 389176
DATEm 01/23/07
SITED 2407 COST #=
TAX%® 7.88 TAX#=
TERMS■ DUE NOW MRKT= R
SERVICE ADDRESS
SUSAN SCHMID
158 WALNUT, ROAD
LAKE PEEKSKILL, NY 10537
Phone: 845-52r,-.1820
DESCRIPTION OF ITEM CITY RATE TAX AMOUNT
01/23/07 PUMP SEPTIC 1000.000 240.0000 7.875 240.00
01/23/07 DIGGING CHARGE 30.0000 7.875 30.01
SALES TAX 21.26
Total this invoice: 291.27
V 'y.... sa•- ...•5•..... • .. .a ._.!r•�. :.�. TiY :1I`.:.....�e...... y.p ....p.. .. �. ..�. a�. ....�.. �•- .w - -��_ .. .. s.. »... ��v�:.�. �1C�.'l,'.....�a... -. \,.��.... �. .. .- .��1..�I ..
• � aft
$10 RETURN CHECK CHARGE
------------------------------------------------------------
SUSAN SCHMID DETACH AND RETURN WITH PAYMENT
Invoice& 389176 Site#= 2407 Cust #=
Statement date 01/24/07 Sub total this invoice
Tax
Paid amount:
Curren invoice balance:
Paid amount:
270.01
21.26
0.00
291.27
N ri -Gene ROed=
Department of Health
1 Geneva Road
Brewster, NY 10509
158 Walnut Road
Lake Peekskill, NY 10537
March 3, 2007
RE: Proposed additionn A- 041 -07
158 -Walnut=Road
(T) Putnam Vallen, TM # 9E24 -1 -16 & 17
Dear Mr. Reed:
Thank you for your time discussing our proposed addition. Attached/enclosed please
fmd revised plans for your review.
Sincerely,
Mark Maxam
Susan Schmid _
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORE' i" to'IVIQGXA11t't,'kdl'�1;1itN
Associate Commissioner of Health
ROBERT J. BONDI
County Executive
., :y;�• : . . �a• rwL1�9► i+ nt l7B 'I�R7'�V�U7tR1�;:'��;.::;;x..- .. ,
Director of Environmental Health
DEPARTMENT OF HEALTH
February 21, 2007 1 Geneva Road, Brewster, New York 10509
Mark Maxam
Susan Schmid
158 Walnut Road
Lake Peekskill, NY 10537
Re: Proposed Addition — A- 041 -07
158 Walnut Road
(T) Putnam Valley, TM # 91.24 -1 -16 & 17
Dear Mr. Maxam and Mrs. Schmid:
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. Plans for the proposed garage have not been submitted. .
2. The legal bedroorim count for the dwelling is three. 'The-potential bedroom count of your
proposed addition/replacement is five. The room titled large office on the first floor and
the room titled family room on the second floor are considered potential bedrooms along
with the three titled bedroom.
3. The addition of a potential bedroom requires this. Department's approval of a revised
- septic sysfeln,plan frorr� a= pro'essicrkal engineer.-
_.. .. _._ . �.. 4'
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.
GDR:kly
Sincerely,
MAN
Gene D. Reed
Sr.'Environmental Engineering Aide
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648
;.ors- v,:....,S,o . �• vc
OWNER'S NAM
M
(;?_% ac A4V*-kV,0t PC(
PUTNAM COUNTY HEALTH DEPARTMENT �4;-rP14,K V61,LCY
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEWAGE DISPOSAL. SYSTEM REPAIR
7
!Svi-A A_V0-VrTvwS1<1 PHONE C -3.62 9- 5_-
SITE LOCATION f _Tf- W s+ LN (rr N_ "7
MAILING ADDRESS t=ee KC
PERSON INTERVIEWED #
Name & R an
. Re (i.e, owner,tent, etc.) Pam Carplaint.
DATE tLsd 9, "7 TYPE FACILITY
V -
PROPOSED INSTALLER ao+G Ca_ -r- PHONE
REGISTRATION #
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 from licensed professional engineer or
registered architect.-
R SO( AC-C "'S-ZINC 7_*-Ne- W I �rA4 I\tCkJ - 100og,4.C_
- L_0C,0r1-10LVJ IWO Z. L16 5
Proposal apprTie� Proposal Disapproved
.. ..............
Inspector's St-g-fiature & Title, Date
Proposal approved with the followincr 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
d. System description (e.g., 1250 gal. concrete septic tank,
drywells surrounded by one foot + graveD.
e. Installer's name and number.
(e.g.,house corners).
three Precast 61 diem. x 61 deep
3. System repair to be performed in accordance with the above proposal and conditions.
Ip as owner, or reported agent of owner agree to the above conditions.
SIGNATURE fj�a_xA oiT TITLE DATE
I
PIES: *dbe MD); YeUcw (Tam BI); Pink Utpliamt)