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Home My WebLink About4756DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 91.26 -1 -54 BOX 36 lirs I I ., 11 P�w r I _ ., Y T A 9p 04756 I l� Public health Director Rachelle Band 20Melnick Place Like Peekskill NY 10537 Dar Ms. Band: Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 August 25, 1999 Re: Addition- Band - Melnick Place No Increases in Number of Bedrooms (T) Putnam Valley Tax # 91.26 -1 -54 Ilave received and reviewed the plans for the proposed addition to the above - mentioned rsidence. The proposal for the addition has been approved as per plans bearing.the approval samp from this Department dated August 24. 1999 .The addition is approved with the following canditions: �. The total number of bedrooms must remain at One without prior approval by this depart -went. The area ofifie existing sewage disposal systeiu,`aid -ilia eiahsioru ar&a,' 'i.nusl tie maintained. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets, etc. lny other permits or variances required are the responsibility of the applicant and the jurisdiction f the Town of Putnam Va11eX f you have any questions, please contact me at your convenience. VM:kg :c :BI Very truly yours, Michael Luke Public Health Technician V PUTNAM COUNTY DEPARTMENT OF HEALTH L Z DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDTVUDAL ADDITION/REPAIR FORM SECTION A: GENERAL INFORMATION Name of Project Z-0" �h`c.�- (T)(V) Year of Construction Size of Parcel TM9 SECTION 'B. TOPOGRAPHY (Please check all appropriate boxes) 1. Cloy . 0Steep Slope gb -entle Slope ❑Flat 2. ❑Evidence of wetland Clow area subject to flooding ❑Bodies of water ❑Drainage ditches ❑Rock outcrop 3. Property lines evident? 4. Water courses exist on, or adjacent to parcel: YES L� O O O� 5. Existing individual wells within 200ft of the existing SSTS? Lam" ❑ SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) 1. Physical character of existing SSTS area. A. ❑Level Mentle Slope ❑Steep slope B. []Well drained oderately well drained ❑Somewhat poorly drained ❑Poorly drained C. Area available for SSTS (Priimmary & Reserve) .( DExtremely limited Somewhat limited Mdequate _ft x ft D. INSPECTION Date Mk."o"exidence of failure Evidence of failure o Inspector DE-vidence of season . al failure ------------------------- ------------------- -------------------------------------- -------- (Indicate North) -- Y L HO SE rx N V) D ------------------------ ---------------------------------------- - - - - -; (1) Indicate location of SSTS A. Size and type of septic tank gallons ®.Metal ❑ ®Plastic B. Type of absorption area 1. Fields ft. 2. Pits 3. Gallies 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. EXISTING WATER SUPPLY ®P` S 6�Shared well [Individual well Maled []Dug * 9Casing above ground CONiBENTS: V1 REPAIRS ONLY: Status: As Built Inspection Required: a '� 0 As Built Submitted: As Built Inspection Done- Inspector: 4- :i PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY, BEDRbb'ivs L o 411#1 r n,tm R Title Pite I AUGa 4 -99 THU 11:25 AV ' PUNAM CTY., ENV HyALTH FAX NQ. 19142787921 P, 1 f -BRUCE R. FOLEY 'Pubho Health Director DEPARTNEENT OF HEALTH Division of Environments! ffealth Services 4 � Qeneva Road y ` Brewster, New York 10509 - Tot278.6130 . (914) Fax (914) OPO ED ri�DTT10N APPLI A7'�ON (FSID N A' Yl STREET A2 A e! j0 ),b U �_ TOWN L)Y�45kdkX MAP # O9 O6 L '0S-4' c oo. aoc� PHUNELA PCHD # MAILING ADDRESS cQ(5 � ► DESCREMON OF NUMMER OF EMSTXNG BEDROOMS 01 PROPOSED # OF )aEDROOMS—_/ (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 klbMit-thlfs form-afid-the following t : Putt►san+:Cumty-Seab Dept,, 4 Qeneva F.d:;: rewster, NY 10509, Phone 278 -6130. 7 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 ,/A 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. liEM USE Comments Feb 98 AUG. 04 '99 (WED) 12:34 COMMUNICATION No : 55 PAGE. 1 AUG- 4 -99 THU 11:26 AM PUNAM CTY ENV HEALTH FAX N0. 19142787921 P. 2 �. «c BRUCE R, FWY, RA. Acting Public ,Health Director DEPARTMENT, OF HEALTH Division, Of Environmental Health Services 4 Geneva° Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: Residence Tax Map -Town L.-R k-C—. Genticrnen: According to records maintained by the Town, the above noted dwolling IS IS NOT in compliance with Town code and the total number of bedrooms on record 15 This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD; OTHER Euildin� Inspector AUG.. 04 '99 (WED) 12:94 COMMUNICATION No:55 PAGE-2 " m ` PUBJECT RESIDENTIAL SITE INQUIRY HDATE. DATE: 08/10/99 372800 PUTNAM VALLEY 91.26-1-54 PRICE ROLL SEC TAXABLE STORIES DPTH PARCEL PRPCLS 220 2 FAMILY RES AREAS H°OPEN BAND RACHELLE TOTAL RES SITES 1 LAND 23.80O 20 MELNICK PLACE TOTAL COM SITES O TOTAL ' 116,700 1950 1.0 1094 1094 ��ucm�c-------- - -- HDATE. 09/13/96 TYPE LAND AND BLD OLDS. STYLE BUNGALOW YEAR BUILT PRICE MOO() EXTWALL MAT WOOD STORIES DPTH ITE SUR F-11 ----' AREAS H°OPEN CLASS 2 FAMILY RES HEAT TYPE ELECTRIC 1ST STORY: ZONING RS NO. OF FIREPLACES -2ND STORY: SEWER PRIVATE NO. OF BATHROOMS 2.0 1/2 STORY- WATER PRIVATE NO. OF BEDROOMS 2 3/4 STORY: UTILITIES ELECTRIC ATT. GAR CAPACITY FIN BASMT: / NEIGHBORHOOD 91301 BAS GAR CAPACITY TOTAL SFLA: / / N IMPR O M V E ET AND U====== TOTAL IMPROVEMENT ITEMS 4 1950 1.0 1094 1094 -' - -- -'- TYPE SIZE! SIZE2 QUAN TYPE FRNT DPTH ACRES SUR F-11 H°OPEN 168 1 101 PRIME SITE 77 102 H2OPEN 6 8 1 IO.BRICK 220 1 IO,BRICK 600 1 U====== TOTAL IMPROVEMENT ITEMS 4 TOTAL LAND ITEMS 1 F1=MORE ITEMS F6=ASMNT INQUIRY F10=G0 TO MENU F4=MEXT RES SITE ON FILE F9=GO TO XREF RPS075S2 11:09:02 1. f , ,'� . ,'• t Of !! i 1 1 AL: ' ! d j fl. to 4 7'10 •. `�;Q T. /_e " .. / •.. ,.4„r {i hi l'1, + 1. �� b V' AIT�" ----'� �� .� ,. � �:��'�°`. ®® �• - .+ �....' 1� x • := .t,„,, ws 'y'.'t fit-? s �;.ij•t � .��' ',' ./l', '.. 6 1 WV ,10/ e ''•a� 1Z -,,e ry ;..gyp i .. (o r-q 22 23,24 Z.5° zc, sit® ® %s; . Aed .. TV o W. � sl !1 Of 1� • 1 1 AL: ' ! d j fl. to 4 7'10 •. `�;Q T. /_e " .. / •.. ,.4„r {i hi l'1, + 1. �� b V' AIT�" ----'� �� .� ,. � �:��'�°`. ®® �• - .+ �....' 1� x • := .t,„,, ws 'y'.'t fit-? s �;.ij•t � .��' ',' ./l', '.. 6 1 WV ,10/ e ''•a� 1Z -,,e ry ;..gyp i .. (o r-q 22 23,24 Z.5° zc, sit® ® %s; . Aed .. TV o W. � sl !1 of ,iw:�'�rriy'q�s✓- .p c ;_I r. . yet 'I,r 7}�"F}7"M_''`'�'�� 1 1 AL: ' ! d j fl. to 4 7'10 •. `�;Q T. /_e " .. / •.. ,.4„r {i hi l'1, + 1. �� b V' AIT�" ----'� �� .� ,. � �:��'�°`. ®® �• - .+ �....' 1� x • := .t,„,, ws 'y'.'t fit-? s �;.ij•t � .��' ',' ./l', '.. 6 1 WV ,10/ e ''•a� 1Z -,,e ry ;..gyp i .. (o r-q 22 23,24 Z.5° zc, sit® ® %s; . Aed .. TV o W. � sl !1 . el`A COT. WhLL l:vr1rLL11V v rrizrvml � y * DEPARTMENT OF HEALTH flrr =Jf. Fn ?irenn;erttn.l Hea1r1t. Seiv�ces �.. .. A4 i.�.._- •.. - �� Y04 PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only - WELL LOCATION STREET ADDRESS: I TAX GRID NUMBER: f,� WELL OWNER NAME-P8 �� .�'�� VATE ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary ,fig IDENTIAL D PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP 0 ABANDONED O BUSINESS 0 FARM ❑ TEST /OBSERVATION O OTHER (specify) O INDUSTRIAL O INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT gpm. /N0. PEOPLE SERVED `T— / EST. OF DAILY USAGES gal. REASON FOR DRILLING []REPLACE EXISTING SUPPLY ❑TEST /OBSERVATION JaADDITIONAL SUPPLY NEW SUPPLY (NEW DWELLING) [] DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH �0 ft. I STATIC WATER LEVEL ft. I DATE MEASURED II 4.6 DRILLING EQUIPMENT ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG O WELL POINT ❑ CABLE PERCUSSION O OTHER (specify): WELL TYPE O SCREENED O OPEN END CASING &OPEN HOLE IN BEDROCK O OTHER TOTAL LENGTH z / _ ft- MATERIALS: Ag STEEL ❑ PLASTIC O OTHER CASING DETAILS LENGTH BELOW GRADE ft JOINTS: ❑ WELDED .&THREADED ❑ OTHER DIAMETER in. SEAL: WEMENTGROUT OBENTONITE OOTHER WEIGHT PER FOOT /4 Ib. /ft. DRIVE SHOE: ( -YES ❑ NO LINER: ❑ YES HMO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (It) DEPTH TO SCREEN (ft) DEVELOPED? FIRST OYES. ONO ;•,,,. HDURS ° �. • - SECQt ;O L_ . .:.: _- _.. _. .� �. -r :.. K ..... . Y' GRAVEL PACK ❑ YES O NO GRAVEL SIZE: DIAMETER OF PACK in, TOP DEPTH ft. '80TrOM DEPTH It. WELL YIELD TEST If detailed pumping METHOD: O PUMPED ; tests were done is in- O COMPRESSED AIR , formation attached? O BAILED ❑ OTHER ; O YES O NO WELL LOG if more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE water Bear- ing Well Oia- let" FORMATION DESCRIPTION poe 1t. ft_ WELLOEPTH a. DURATION hr. min. DRAWOOWN It, YIELD . gpm. Lancl urlace /i LljLL r f n xaT✓ WATS CLEAR TEMP. QUAL.RY CLOUDY HARDNESS O COLORED ANALYZED? O YES O NO ANALYSIS ATTACHED? O YES ❑ NO STORAGE TANK: TYPE CAPACITY GAT.. PUNT? INFORMATION PE_ 3,1141U— CAPACITY MAKEi/✓' '^ DEPTH MODE VOITAGE'�� HP % WELL DRILLER NAME DA AooRES StGfrkTtlRE AG�I J/ t5:0