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Home My WebLink About4737DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 91.25 -2 -49 BOX 35 04737 or or U-ih-1 T , rol. , 04737 03/28/2000 20:58 r. -- 9145260030 FRANKIE RICE PAGE 02 ONM'S RM SITE WC•ATIM PEA nvYS® MQ. �' Sc PCHD COWO i.�',_� tonne a Relationship (i.e, owner tenant, etc.) 3 TYPE PP91 c REGISTRATION # IL1 ft=mul sketch locating all adj NOM: Repair must be in same location and Different location may require submittal of scent wells) r of am type as original. sewage disposal systm. proposal from licensed Inffessfonal engineer of g�� /a p; cnxl Disaoved .. ,. s Signature i with he follanna VMW Vims: . Procaunment o� any Tom permit, it appliw«e. 2,. %ftisaion of as built repair sketch in duplicate showing: a. Owner's 'MA A. b. Site Street Name,.Town and Tax yap n:=ber. c. Location of installed omponents tied to two fixed points d. System description (e.g., 1250 gal. corcrete septic tank, drywalls surrcw:ded by one foot + gravel). �e.q.,house cornets) `'.:, three pest 6' diem:;; x if ees) e. Installer's name and nuber. 3. System repair to be performed in accordance with the above proposal and oenditions . i, :&a :cm er, or d agent owner to the above conditions. OUAM TIDE O11TE .3 �61 rr an: *Ate ow); yei1 can ar); � .z PC -RP 97 1 03/28/2000 20:58 ` 9lu5260035 FRANKIE RICE .. .. _ ...:sue., BRUCE R. FOLEY, R.S. Acting Public Health DEPARTMENT OF HEALTH Division Of Environmental Health Services Geneva Road, 6re�vster, New York 10509 (914) 278 -6130 P.RQ=�OS =D ADDITiON APPLICATICN _ ( /RESIDENTIAL ONLY) S T P ==T •d ye'h zoel r e. TOWN ri-1 "v l/ TX ht4P . l p K;HD PERMIT 1�" %ILINO ADDRESS '�(�• �c.� 3�/2 ,�� C�[ �G �%� io3-3 2 Description of Addition Nuimber of existing b =droh7.s Proposed number of bedrooms fro -: Certificate of Occupancy or. Certification from Buildin: Inspector e,.(L any addition which is considered a be:;raon requires formal roval of plan's (Construction Permit) prepared by a Professional Engineer.:o.r Registered Architect in accordance vrith applicable sections of the Putnam County Sanitary Code Please submit this form and the following to P' TNA!M- .COtJ•NTY HEALTH DEPARTMENT, 4 Gz�;= V.�,,.F�OAD., B rcj'ISTER, N P; -pane 27.8 -6130 vti 5. cif Certified Check for $100.00. ,2:j Sketch of existing floor plan (all living area including basement, if any) Non - professional drawing is acceptable. 13.,j Sketch of proposed floor plan. f7" Non professional drawing is acceptable`-' ' 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 Tarn or Certification from Building Department of legal bedroom count of dwelling. OFFICE USE Comments and /or conditions application August 1995 July 1996 (Revised) 4 .. .. _ ...:sue., BRUCE R. FOLEY, R.S. Acting Public Health DEPARTMENT OF HEALTH Division Of Environmental Health Services Geneva Road, 6re�vster, New York 10509 (914) 278 -6130 P.RQ=�OS =D ADDITiON APPLICATICN _ ( /RESIDENTIAL ONLY) S T P ==T •d ye'h zoel r e. TOWN ri-1 "v l/ TX ht4P . l p K;HD PERMIT 1�" %ILINO ADDRESS '�(�• �c.� 3�/2 ,�� C�[ �G �%� io3-3 2 Description of Addition Nuimber of existing b =droh7.s Proposed number of bedrooms fro -: Certificate of Occupancy or. Certification from Buildin: Inspector e,.(L any addition which is considered a be:;raon requires formal roval of plan's (Construction Permit) prepared by a Professional Engineer.:o.r Registered Architect in accordance vrith applicable sections of the Putnam County Sanitary Code Please submit this form and the following to P' TNA!M- .COtJ•NTY HEALTH DEPARTMENT, 4 Gz�;= V.�,,.F�OAD., B rcj'ISTER, N P; -pane 27.8 -6130 vti 5. cif Certified Check for $100.00. ,2:j Sketch of existing floor plan (all living area including basement, if any) Non - professional drawing is acceptable. 13.,j Sketch of proposed floor plan. f7" Non professional drawing is acceptable`-' ' 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 Tarn or Certification from Building Department of legal bedroom count of dwelling. OFFICE USE Comments and /or conditions application August 1995 July 1996 (Revised) ri 0 DEPARTMENT OF FIEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 F='-(914) 278-7921 March 23, 1998 Walter Liske P.O. Box 342 Lake Peekskill NY 10537 Re: Addition - Liske, 7 Sylvan Road No Increase in Number of Bedrooms (T) Putnam Valley TM# 91.25 -2 -49 Dear Mr. Liske: BRUCE, .. R...FOLEY Public Health Director 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 March 20, 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. 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. 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, Michael Luke ML:tn Public Health Technician cc: BI (T) Telephone (914) 528 -6842 Lake Drive • Lake Peekskill, N.Y. 10537 Cleaning Specialist of EASTERN STATES SEPTIC CO. EASTERN TRENCHING DIGESTERS DRAINAGE BEDS IMHOFF TANKS ANY TOWN OR STATE SEPTIC TANKS SEPTIC TANKS CESS POOLS INSTALLED CATCH BASINS K. R. LIETZ & SONS CITY PIS. PLANTS BOOSTER PITS Raymond K. Lietz b Kenneth J. Uetz t SWIMMING POOLS FILLED Coil PITS Owner 3 Operator OIL STGRAGE TANKS INDUSTRIAL SLUDGES' 1&�' 157a�- - S;� rt CA, t" M '4 .i i i N Ism o.ve.b le 7.�,, A'M C PUTNA14 COUNTY L,12ARTMENT OF HEALTH Urp-'E PLANS APPROVED F'OR, BI (301,fi COUNT OlI.LY; T D-- -to ,4 7-r), c ic, ra .1 i V PUTNA14 COUNTY DEPARTMENT OF HEALTH MUSE PLANS APPROVED FICR L ,,?, BEDROOM COUNT ONLY; EDROOMS ti nJ po 7t `4 3 vQx 9 L D °r V i YWI Pow v .I - -- lot i t NT'ilY OF HEALTH HOUSE PLANS APPROVED FOR BED. OO;d COUNT ONLY; � pp ",,,,� 3ED1:OOMS Signature F4 Title - Date PUTNAM COUNTY DEPARTMENT OF HEALTH omplaint NO. COMPLAINT.OR SERVICE REQUEST R - ..__;PREFERRED TO^ " ;c jy. TAKEN BY ML TELEPHONE - CALL! IN PERSON LETTER CONFIDENTIAL REQUEST FROM PCHD TELEPHONE ADDRESS ENVIRONMENTAL HEALTH: Sewage Nuisance x_ Public Health Nuisance Chemical Emergency Individual Water Other COMPLAINT OR REQUEST Liske, 7 Sylvan Road Septic failure. ACTION TAKEN BY DATE FINDINGS .. FOLLOW .UP INSPE ION-.(s) DATE FINDINGS ��6 Ste- G�-�e -�5'� . %u�. ✓, 3 e_,�� DATE (o_ FINDINGS_ /12- Y N o s c. (I,G -�i� PROBLEM ABATED DATE 1,,0 I � PERSON NOTIFIED j V E� S e c.,� 4_1 �� y L-c. y y r� . ESTIMATED TOTAL MAN HOURS SPENT 7j PC -CR 97 I Sheet_ of�_ PUTNAM COUNTY (DEPARTMENT OF HEALTH DIVISION-W-ZI VIR 3INMENTAL - HEATLH -SERVICES FIELD ACTIVITY REPORT N A W: L i's L- Tel: ' ADDRESS'. -7 Si N Y Street Town State Zip PERSON IN CHARGE 31- 12.r 9 ? OR TNTFR VTFWFT): T)atP: Name and Title TYPE OF FACILITY: FINDINGS: L Z G1 dLt ^ h �> r ✓` L�Ji1 ►�r S ha G et V c� �° q.. 1""'a Signature and Title RFPnRT RFC'.F.TVFT) BY. I acknowledge receipt of this report: SIGNATURE: 02/96 Rev. lowY4_ hT2v.'! L°. me$ "8R790e'2Cf�^P ?V.IX.'MO�iYI� Cs':a:: "v.aC;i- �': .,�-�n'.. ��' �. o�aw? S'" aU'. ;::wia:..ew�;s °'•.:e.:n.:,sY =.. . 4) BRUCE R. FOLEY Public Health Director. .::yw _ .F.� .. .. ':%�: 'eV�.db�.".•+,; � .�.raw��.S� a .c� -. K. '.,�::..�,y��. DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 CERTIFIED RETURN RECEIPT REQUESTED March 9, 1998 Walter Liske PLEASE REFER CORRESPONDENCE TO: PO Box 342 NAiI Mike Luke Lake Peekskill NY 10537 TITLE: Public Health Technician PHONE: (914) 278 -6130 ext. 127 YOU ARE HEREBY NOTIFIED that non - compliance with Article III section 4 of the Putnam County Sanitary Code where evidence of sewage, discharged onto the surface of the ground was found at 7 Sylvan Road, Lake Peekskill, TM# 91.25 -2 -49 by a representative of this Department on March 9, 1998. It is believed that you are responsible for correction. of this condition. If you are not responsible, you are requested to immediately notify the inspector indicated above. Please be advised that appropriate steps must be taken immediately in order that the sewage overflow cease by arranging for the septic tank to be pumped out and maintained pumped until the proper repairs are made to the system. Approval of proposed repairs must be obtained from this D_ epartment..pripr to any alteration or rebuilding o£ existing disposal systems. An application is enciosed. - - Failure to pump the septic tank by March 20, 1998 and further, to correct this condition by March-31, 1998 will make you liable for additional penalties provided by law, including prosecution on a charge of committing a violation punishable by a fine or imprisonment, or both such fine and imprisonment, as prescribed by law, in addition to such other action as may be prescribed. A reinspection will be made. It is sincerely hoped that the above mentioned further action will not be necessary and that you will cooperate by securing the correction of this condition. ML:tn enc.-Permit Application cc: BI (T) For the Public Health Director Very truly yours, Bruce R. Foley, R. S. Public Health Director By: Mike Luke Public Health Technician . .z �. �., � .. .v^. ;j,.r•r.; a: � �'{(�5 /� c(p 'j� j�¶$}�p� �ry,�y'(�]''p��y �r �'j{�' �q ._ -�:.. ;:tr ::.* ., S'-,. 5 °•'•° ,r :,�.' -oR� .A.c : �iw.a^� ..c LLll N( CM ® IIU Ct1YOU �p1 TY1 dJ1G11 [C1CPHA�LYR�TM L�UN/1V T W ®1C�F 1L6 1J�j�E1A 111®LT•1VH • Division of E nvironnmennall HeaRth Services Facility: L s Town:— Time: Date: 3 . / � °/? Telephonne # CaHen''s Named WSCUSSION: SGT (Le .-16 4- s Q ., s,ep , /�- f p6 "5 414- Signed: � � Date: 3 1 . q br: Rev. 6/97 Sheet _I of PUTNAM COUNTY DEPARTMENT OF HEALTH `�. b,: � . - L.. , y V �:w w+.• . - . w �: •� -7. •.� `! .. �:V'.'' ... .liy"wv �p�, T.+�.r :. �wi 1� FIELD ACTIVITY REPORT NAME• L i S Le Tel: ADDRESS: S7 I VC4, " YV A ( Street Town State Zip PERSON IN CHARGE ()R INTFR ITFWFD: - -- Dnte: 3 �7 Name and Title TYPE OF FACILITY: � . a� �� .P�FINDINGS • P b S ' �( v t - � Signature and Title RFP0RT RECETVRT) RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: Rev. Sheet of PUTNAM COUNTY DEPARTMENT OF HEALTH "RO, --SERWC-kS; DWISION-OF ENVI NMENTIALL If-E-A-T15H FIELD ACTIVITY REPORT NAM-F.: L Tel: ADDRESS: -7 Avll( Street Town State Zip PERSON IN CHARGE ,� l� /� OR TNTFRVTPWF.T). 1"rS, T),q t t-. Name and Title TYPE OF FACILITY: FINDINGS: v 4-6 -7 s 5 -r-C& t, Lf-A, C� Al 4 -e � o 4- �jo 0 va TNQ,PF.C-TnR, TFT, Signature and Title RFPQRT RFCFTVF-T) BY-0 I acknowledge receipt of this report: SIGNATURE: 02/96 Title:. Rev � m 0 fl m IzF anC mad xc C x D xi r <N zo= 2(4k i'6N56D V40c\ %14 141 N bOA9.\tlns. C :V Q6n *�V� 'ilk '' Wly ` •.. .. � � Q O 4aozc a 4�O _> 11 p wj// a so .•( 1 __ .T X i a v\ dt C 4i R �! z Z to �a�., \�C C,� i, q" ` �tn p� 4 Z ^. �n0 i a l /C'M. genre Z: ° moo. , (Lry�4 ON ?1' Bor 4 bo 0 0 P y •.... '` 1 � SI � it �z..:• �`�. ��(� o ' • ., � ,off -� .os.oar / �+ �� a l � o v . � •S N ,ref �,t,¢w. � C O � o > D m [1 0 % r" .0 C 2 �o DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva load, Brewster, New York 10509 (914) 276 -6130 Putnam County Dept. of Health d Geneva Road Brewster, NY 10509 BRVCE R. �ealth OLCY. a g Acting Public 0 „e:to, Re: _L:.k Situ, �J. Residence Tax Map - 47/ ,g_s-4::t9 ToNNm % (� Gentlemen: According to records maintained by the Town, the above noted dwelling is - Y JS-NOT in complianec with Town code and the total number of bedrooms on iecord is ._T2) This information has been obtained from: CERTINCATE OF OCCUPANCY: ASSJESSORS RECORD: OTHER 'S� a ,rf - M rA'E r_�IkoM: t:--; Building In pector PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES PRCOOSAL FOR SEWAGE TREATMENT_ SYSTEM REPj YES ISO Internal Use Only PERMIT # IG� SITE LOCATION OWNER'S NAME MAILING ADDRESS APPLICANT DATE TOWN TM # / 1 Name & Relationship (i.e., owner, tenant, contractor) (00 FACILITY TYPE �.r PCHD COMPLAINT # PROPOSED INSTALLER rr-L PHONE # ADDRESS %12 /'14/l�i'-l' REGISTRATION /LICENSE # 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. I, as owner,agree to the cgneitions state-"n this form / / SIGNATURE t� �_ �' TITLE DATE F l/ (owner) I, the septic installer, agr o.,comply,.wit e.conditions of this permit for..the septic system repair _ - _ - SIGNATURE TITLE DATE (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 backfilled until authorization to do so has been obtained from the Department. Hm i CftNAL U,t ONLY Proposal Approved Proposal Denied El Ad�_b " Ij / -i zo Inspector's Signature & Title Date g Expiration Date Repair proposal is in compliance with applicable codes Yes No ❑ COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 Repair Permit issued in last 5 years ❑ (Slot in Watershed ❑ L� Repair within Boyd's Corners, W. Branch or Croton Falls Res. Delegated ❑ ❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review SITE LOCATION OWNER'S NAME MAILING ADDRESS APPLICANT DATE TOWN TM # / 1 Name & Relationship (i.e., owner, tenant, contractor) (00 FACILITY TYPE �.r PCHD COMPLAINT # PROPOSED INSTALLER rr-L PHONE # ADDRESS %12 /'14/l�i'-l' REGISTRATION /LICENSE # 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. I, as owner,agree to the cgneitions state-"n this form / / SIGNATURE t� �_ �' TITLE DATE F l/ (owner) I, the septic installer, agr o.,comply,.wit e.conditions of this permit for..the septic system repair _ - _ - SIGNATURE TITLE DATE (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 backfilled until authorization to do so has been obtained from the Department. Hm i CftNAL U,t ONLY Proposal Approved Proposal Denied El Ad�_b " Ij / -i zo Inspector's Signature & Title Date g Expiration Date Repair proposal is in compliance with applicable codes Yes No ❑ COPIES: PCHD; Owner; Installer PC -RP 99ML Rev. 2/07 r� I I G ,I) r 1 �( f 1 -51 sj �v� . j II