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HomeMy WebLinkAbout4732DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 91.25-2-39 BOX 35 1 I ' r' T I Lm I I T Ir Z.: 04732 _BRUCE R._ FOL)ay.r _ =a• ; �` �' "y' '�' "�TPublic"7Ye'alth Director) DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 TeL (914) 278-6130 Fax (914) 278-7921 PROPOSED ADDITION APPLICATION fRESIDENTIA.L• ONLY) STREET Ix"?m TOWN MAP #. 9 /,mss � 1 NAME `' & %9 4, S PHONE�_3 -76' PCHD # 3 9� MAILING ADDRESS � l''�L "�°' � � L-� �E ReJU/11AY71 DESCRIPTION OF ADDITION LCM 3 NUMBER OF EXISTING BEDROOMS 3 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 accordance with applicable sections of the Putnam County Sanitary Code. F�lease submtthis'forirl'and the followuigto Putnam County Health Dept., 4 Geneva Rd., 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 Feb 98 ';a;', ";;.� ,sas..trl —N:f -� i>!. �,:` � :.wc�•ciZF�1Tr'^.t+w- y.•Y�m�9.- _e1 ^IS`�'�:�y. BRUCE R. FOLEY U DEPARTMENT OF B EALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 December 9, 1998 William Soto 8 Spruce Street Lake Peekskill NY .10537 Re: Addition - Soto, Spruce Street Increase in Number of Bedrooms (T) Putnam Valley, TM# 91.25 -2 -37, 39 Dear Mr. Soto: 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 latest revision date of December 9, 1998 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: lre�arM 6f i`i - eXrsrf g 1Mage diTp&a '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, restructures 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. WH:tn cc: BI (T) Very truly yours, William Hedges Sr. Public Health Sanitarian a-r. DEPARTMENT. OF -HEALTH: Division Of bivironmenull Health SCrViC . C S I Geneva Road, Brewster,. Nc�w, :York'; 7050;9: (910 .278 -6130 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............. PLILIlaIll County Dept. of Health il.Gcncva Road Brewster, NY 10569 ILLS: R6sidmice Tax Mal) Town Gmit1cmen: Accord.ing to records maintained by Itic'fown,-the. above noted dwclling IS in CoillplialiCc with Town code and the total ilumbd of Bedrooms on record is 74R-CE This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RE-CORD: 9 -!; O Jo • O i t di 'oo� LH'xci w i LOT ND.. cv Z / oIJE 1 STORY ' � I � yp'���J•.`�1y2r•.:t^c s+n.t a •v.•V'h a+y=, m, �Q(14' ALUrt. LOT AO. .37 OVER O WELL, .._.. _ 1 "L,$3' •' :1 WOOD DECK ,Z.12. - I .I .02 CLEAR S. I =10 -00 "E. /20.00_ LOTS N0.'.::''':.. 1 50 1 49 48 47 2 46 I. 5URVEYED WITH SNOW ON GROUND BE /NG' 5PO Oki z7 /N .1. 5B, 27_ ;=•AS�..SNOWN Oh' MAP N0. 1858, til t N71TLE0' "LAKE. PEF- KSKtLL SE 4 i G.T! F/LEO.lNTHE OFFICE. .I "OF+TNE OUAl.TY CLERK OF buTNAr1':000iI,6TY ;" CARMEL, NEW YORK : AL50 FILED 9J THE OFF( CE'CKTNE COUNTY CLERK OF `,F- TGNE'STER i 0(JNTY, WHITE PLAIN_ 5 ;NVb YORK AS MAP NO. I CERTIFIED TO: _D'4LE FUNDING CORP. 1 Z Ste` 4- S.0• N•Y, M.A. , KENNE_T_H_PREGNO ( r AGENCY, 'x PP WG .75/927_ —7 O4 �le � t� .� -z 3 ' �IANUARY '2/, 1984 Carfifutions,'hareon'.,a valid for Bank, SURVEY OF PROPERTY 4z 7; t • .1 _« , Re .- •, �i w.: C • only. Certiiicafions are not tramferable to . FOR Ir 0 subsequent Bank, T;fle Co. or Owners -SPR 6CE 5TR EET ,- ' ti .. All certifications hereon are valid for this COBB JOHN SALVATORE ROMEO map and copies thereof only if said map or POLE J N.Ia — /0: 00 W. 20.00• iron p. TOWN OF PUTNAM VALLEY 1'NORTHRIDGE ROAD " STONE bit O Jo • O i t di 'oo� LH'xci w i LOT ND.. cv Z / oIJE 1 STORY ' � I � yp'���J•.`�1y2r•.:t^c s+n.t a •v.•V'h a+y=, m, �Q(14' ALUrt. LOT AO. .37 OVER O WELL, .._.. _ 1 "L,$3' •' :1 WOOD DECK ,Z.12. - I .I .02 CLEAR S. I =10 -00 "E. /20.00_ LOTS N0.'.::''':.. 1 50 1 49 48 47 2 46 I. 5URVEYED WITH SNOW ON GROUND BE /NG' 5PO Oki z7 /N .1. 5B, 27_ ;=•AS�..SNOWN Oh' MAP N0. 1858, til t N71TLE0' "LAKE. PEF- KSKtLL SE 4 i G.T! F/LEO.lNTHE OFFICE. .I "OF+TNE OUAl.TY CLERK OF buTNAr1':000iI,6TY ;" CARMEL, NEW YORK : AL50 FILED 9J THE OFF( CE'CKTNE COUNTY CLERK OF `,F- TGNE'STER i 0(JNTY, WHITE PLAIN_ 5 ;NVb YORK AS MAP NO. I CERTIFIED TO: _D'4LE FUNDING CORP. 1 Z Ste` 4- S.0• N•Y, M.A. , KENNE_T_H_PREGNO ( r AGENCY, 'x PP WG .75/927_ —7 O4 �le � t� .� -z 3 ' �IANUARY '2/, 1984 Carfifutions,'hareon'.,a valid for Bank, SURVEY OF PROPERTY SURVEYED'' xn,r,: „•�.,.,•� .....7iNa`,Co. ,,3: Ownen,,for thisirana +c#ion BROUGHT TO DATE— only. Certiiicafions are not tramferable to . FOR - - -_. _._.___ subsequent Bank, T;fle Co. or Owners JOHN BROUGHT TO DATE F LORI ' ti .. All certifications hereon are valid for this COBB JOHN SALVATORE ROMEO map and copies thereof only if said map or _y V _.__. , copies bear the impressed seal of the snr- SITUATE IN THE C tn,nsce• :, l�sul �urrr ..r veyor whose signature *appears hereon. TOWN OF PUTNAM VALLEY 1'NORTHRIDGE ROAD " ••M is hereby certified that this survey was PUTNAM COUNTY PEEKS ILL. N. Y: prepared in accordance with the esist;ng _ Code of Predice for Land Surveys adopied NEW YORK oY she Kew York State Association. of Pro., . E. & L. 5. ,NfYS LIC. NO. 0278.28 i.x;on.1 Land'Svr.eyors.•' SCALE' t - GC:• ENCROACHMENTS BELOW GRADE IF ANY NOT SHOWN SURVEYED AS IN POSSESSION i� W <s z, 1, i; at PUTNAM COU V N DEPARTMENT OF HEALTH i HOUSE PLANS APPROVED FOR ?9 BEDROOM COU-M ONLY: s ��— BEDROOMS +' 2 — 3`I ?7 i :-1 �1I. , �-+-- •- �`- `.����� /•',.�.�. ''l„ ••i�4. mil.» _ -! 1.' 1.... cif.' -^_ / •• J � -u I Coo Q 1. I;. ` `a, SP 1 V •` Q S!'i�- I J , -I _ ii''•: I u .. �, _t � ' °` �,' _mom � '� .fl G'`!✓� eoo. 000 JF € o CA E i. •i i I � � ..t I I -NAM .•11Y .iRTkfNTOFHEALTH ��r HOUSE PL Rt}�`Ep FOR �fL ' P c ...... QEDROOAF COUPJ JLY; i - - c { L1 ANt1:: -7�� - r —2—TECROOL'S ' .M - �O v S�ralulA We Da Ee .t 1 `A Y '7 P I C� GN\ U•tJL.h- r � • nn.` e alb� 43.bv LT I 4 � -- i. CiD it i I. wwvo7 y 43-b Ti u i t 1 i CtDS�(_ c PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDIVUDAL ADDITION/REPAIR FORM SECTION A: GENERAL INFORMATION. \Tame of Project , ✓u.ze. S (T)(V) V' TMIT Year of Construction Size of Parcel SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. L /Hill - DRollina OSteep Sl oe ®Gentle Sloe ®Flat Y P P 2. ❑Evidence of wetland Clow area subject to flooding ®Bodies of water DDrainage ditches Clock outcrop 3. Property lines evident? 4. -Watehcourse� 4xist cn, or adjacent to parcel: 5. Existing individual wells within 200ft of the existing SSTS? L`' U SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) 1. Physical character of existing SSTS area. A. ❑Level ®Gentle Slope OSteepslop,e B. OWell.drained OModerately well drained Erso"mewhat oorle drained OPoorly drained P Y C. Area av ilable for SSTS. (Primary & Reserve) Extremely limited OSomewhat limited ®Adequate $ x ft I D. E\SPECTION alNo .evidence of failure Date Inspector TIEvidence of failure UEvidence of seasonal failure - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - (Indicate North) FOUSH --------------------------------------------------- Jr-0 (1) Indicate location of SSTS f4 - A. -Size and type of SePLIC WIM gallons 0 `'' A Metal OConcrete UPlastic B. Type of absorption area 1. Fields ft. 2. Pits 3. Gallies ft. (2) Indicate setbacks, front street, backyard, and side yard dimensions (3) Show location of well (4) Show location of driveway (5) Note physical features (steep slopes, rock outcrops, streams /wetlands) SECTION E. EMSTINIG WATER SUPPLY 7-1 CIPWS UShared well 01�divid well DDrilled Mug -0 a�sing above ground (I- it (4 ve- COINMNTS M:d, GV�Nk PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES F ;APPl lC/ ION TO CONSTRUCT .A 1�1/A,TER WELL –��� please print or typet?(i3erlrifit' A k3�F r Well Location Street Address: TownNillage: Tax Map # ,9—,37 .VII Map Block l ,s p Block Lots) Well Owner: Nam e::,,�, Address: �063 7 P�o� #: c ' Sr� 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 4a. gpm #People Served Est. of Daily usage gal. Replace Existing Supply Test/Observation Additional Supply Reason for Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason U101 LA4eJ I 16J 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: 0 �/1� Address: ����Sa l'ae.w l Is Public Water Supply avalilble on site? ....................................... ............................... Yes _ No4L Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Ae Date: X10 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 Departmel 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. one. APPROVED FOR CONSTRUCTION: This approval expireslwtfyears�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 Commissioner of Health. Any revision or alter ion of the appro plan requires a new permit. Well to be constructed by a water well driller certified by Putnam C u y. Date of Issue g 2-0 to Permit ng Official: Date'of Expiration 0 03A1('C- Title: JA A i'& 4XA Permit is Non - Transferable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 Rev. 3106 . 'Vd /LU /ZUlU UV:4U r'A4 54OZZ030OZ rUND LA VAr,=L ActiveNiew Item Processing: Pmt Item Page 1 of 1 i Putnam VOTIOUniv Autional paint Aug. Z,.,zor.. ; CC 60273 RAY Teaxos � j 200.00 PDX TAM •��► d b� )VOL . 01p, NOT UAW ovER s;= �° ©60 ?3u° tb0 2 �q' ®6B08oa W 0001 24, w I - i i Posting Date: 08/18 12010 Posted Account: 1000012 i Check No.. 80273 Amount: $200.00 External Trace: 339010054 Routing: 021906808 http : / /10.164.88.51cgasplpzntitem. asp? fn= %5C %5CCQ_SERVEZt %SCavilp %5Chisi imag... 8/20/2010 r -- PUTNAM COUNTY DEPARTMENT OF HEALTH RECEIyEp AUG DIVISION OF ENVIRONMENTAL HEALTH SERVICES • o a 3 c �.•- .--APPLICATION- T06db` as 6C 4 Ile I Vi please print or type PC�HDSPermit > #��`;w e. Well Location Street Address: Town/Village: Tax Map # ? /.a6- a ' V Map Block Lots) Well Owner: Name: Address: Aoy�7 P4p#: prrJ ZA.P,'g Use of Well: _Residential _Public Supply Air /cond /heat pu p _Irrigation 1- Primary Business Farm Test/monito,ring —Other(specify) 2- Secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served 15 Est. of Daily usage gal. Replace Existing Supply Test/Observation Additional Supply Reason for Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ....................................................... ............................... Yes _ No X Is well located in a realty subdivision? ........................................... ............................... Yes _ No X Name. of subdivision Lot No. Water Well Contractor: Address: U y Is Public Water Supply available on site? ....................................... ............................... Yes _ No se Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: '6y11111J 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 Departmel 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 Commissioner of Health. 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 Date of Expiration Permit is Non - Transferable Permit Issuing Official: Title: White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 Rev. 3/06 ft r PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES 3. WELL COMPLETION REPORT Well Location Street Address: Town/Village: Tax Map # GPS �! Ma g� Block ) Well Owner: Use of Well: I - Primary 2- Secondary Drilling Equipment Well Type Casing Details Screen Details Well Yield Test Depth Date Well Log If more detailed information descriptions or sieve analyses are available, please attach. If yield was tested at different depths during drilling list: Date,Well Cornpleted'� ' T d3 Well DrlllerName�,r Pump;fi er Nar Address: Residential _Mublic Supply *Air cond /heat pump _Irrigation Business Farm Test/monitoring —Other(specify) Industrial Institutional Standby Rotary _Cable percussion W—Compressed air percussion _Other(specify Screened _Open end casing Open hole in bedrock _Other Total Ing trade ft. Materials: Steel Plastic Other Lengt KIb�w� ft. Joints: Welded Threaded Other Diameter --(p—in. Seal: Cement grout Bentonite Other NVeight per foot _Ib /ft Drive shoe: Yes _ No Liner: _Yes Diameter in Slot Size Length ft Dept to Screen Second _Bailed _Pumped deasure from land surface - static (sp Compressed Air I Hours _— Yield Depth From Surface wen Diami ft. ft. Water Bearing in .and Surface % Gallons Per Minute Pump Type _ Depth Voltage Tank Tvpe 0 Developed? _Yes No Hours Formation Description anK intormation Capacity Model HP Volume NOTE: Exact Location of well with distances to at least two permanent landmarks to be provided on a separate sheet/plan. White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 Rev. 3/06