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73.08 -1 -38
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03394
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
David & Janice White
27 Jeanne Drive
Putnam Valley, New York 10579
Dear Mr. & Mrs. White:
April 4, 2006
ROBERT J. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
Re: Addition Approval — 27 Jeanne Drive
No Increase in Number of Bedrooms
(T) Putnam Valley, TM# 73.08 -1 -38
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 April 4, 2006. The addition is approved with the following
conditions:
1. The total number of bedrooms must remain at four 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;�or sbower_ call
�4. The approval is for the proposed changes only. This approval does not validate any
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 your convenience.
Sincerely,
Joseph Paravati
Assistant Public Health Engineer
JP:cj
cc: Building Inspector, (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 Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
ORETTk MOLINAR1_, FtN,1VISN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ADDITION APPLICATION RESIDENTIAL
ROBERT J. BONDI
County Executive
Kz6 �
4 1 G.
STREET �'l kpi�orc_ D9 TONVNH �PCIHD# X MAP# r J
NAME PHONE �'� � v .� 3 �' ' O's
MAILING PIS- - 5-020
AIDIDRESS
(DESCRIPTION OF
AIDIDITION Ji c�� S/ N b (Z S ", R �.� 1d
y
NUMBER OF EXISTING BEDROOMS 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.
Please submit this form and the following to Putnam County Health Dept., 1
Brewste.N _:1:0509, Fl:6ne •( 845) 278- 6130.
Geneva Rd,
1. ertified check or money order for $100.00.
2. ketches of existing floor plan (drawn to scale, all living area including basement)
3. V Two sets of proposed floor plan (drawn to scale — with name, street and tax map #)
*lion- professional sketches are acceptable
4. Copy of survey showing well and septic locations to the best of your knowledge.
Incl e date of installation if known. Label all wells and septic systems within 200 feet
the property line. Contact this office with any questions.
5. Copy of Certificate of Occupancy from Town or Certification from Building
Dept. with legal bedroom count of dwelling.
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
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509'
PUTNAM COUNTY DEPT. OF HEALTH
1 GENEVA ROAD
BREWSTER, NY 10509
To Whom It May Concern:
Re: 6��
Residence
TAX MAP4 q5.7--
ROBERT J. BONDI
County Executive
TOWN '=*>L(YAM \/A
YEAR BUILT
According to records maintained by the Town, the above noted dwelling,
IS IN COMPLIANCE WITH TOWN CODE.
IS - NOT .- :....sr..
COMPLIANCE W'ITH'TOWN CO'DE__-
LEGAL BEDROOM COUNT IS
-
This infonnation has been obtained from:
CERTIFICATE OF OCCUPANCY: V
Building Inspector
c7l/ -7
Date
CERTIFICATE OF OCCUPANCY
... ...... .. _.- . ...... .
Water Supply Section (845) 225-5186 Fax (845) 225-5418
,Environmental Health (845) 278-6130 Fax (845) 278-7921
Nursing Services (845) 279-6558 WIC (845) 278-6678 Fax (845) 278-6085
Early Intervention/Preschool (845) 278-6014 Fax (845) 278-6648
S>1�](I.te,`�lb�]LF;R,_l6IBD, MS, FAAF
Commissioner ofHeallh
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
November 3, 2005
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
David White
27 Jeanne Drive
Putnam Valley, NY 10579
Dear Mr. White:
ROBERT J. BON ®I
County Executive
Re: Addition — W7 hiitye �7
:' tYl' P' CCIiI�GI"QI- IJeQ1'BVITIS- --' ---
27 Jeanne Drive
(T) Putnam Valley, T.M. 73.8 -1 -38
I have received and reviewed the plans for the proposed addition to the above - mentioned
residence. Based on the information submitted, the above mentioned addition cannot be
approved for the following reasons:
1
:� _..... .c: .. 2-.
3.
4.
It appears that the septic tank will be less than the required 10 feet from the
addition
The r.cr. &ti .,n- r- oom:- t...- ,.:on���rey -a l;ot§�*iAl.bedruom:. .... ::.. -..
The legal bedroom count for the dwelling is four. The potential bedroom count of
your proposed addition is five.
The addition of a potential bedroom requires this Department's approval of a
revised septic system plan from a professional engineer.
Please revise the proposed floor plan to reflect no more than four 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.
ML:cw
Very truly yours,
0 -11 a-4
Michael Luke
Public Health Sanitarian
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 -6648
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COL
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HEALTH r
'A
.,Village'
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-Owner
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Building Lot A
rea p
AT
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r .o
i'ii'4idrobriii Totai'. Hi6liable ',S;5;ace Square Feet'
%;Vidthtre'nch
S'ip6rife'� Sewieragc,,Systenn to�,Icoi�iist to. f�. �.z 4>1= .
To b@ constructed b "G AddrA
v.
7
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Fi6rn -
�.S upp y K Ru6k
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ly 't be drillid 6�f.
Oy4ta, up
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,dtfi,6 Aoulrerni34s
C
4
�,th �,a'ratiitsewag , e disposal �systern,
I represent'-that'l Arn,.who6'.�a'nd" lresponsibldjoi.t e Si n I cation the
.�pq�m - * - - '�'Ip�j:jsicr -i r , Ahali
p!e!ely, - " , ,
16 - t
_9y� --as" _�iflb�'c6nstr -ag�shbWn e. Moar�ds, ru les:a nd.,!pqu [at ions of the-Putnarn i
it
—6- cribet!" Uct6d, a_ ep "ere Co __ A)
Rn, . q,,appr.oveo" e,
H 0 1" )n�r�-o_jjj'6l6jf6jj_th , )i a -sCtoiy io-ihe Coin" i i -H ealthwill.
tie submitted to '•the �County; �Departrnent;-!,o Ilth, �anqj,�at.( ere( ert ifri fii bvxons &20. fle
- 15 CIP -T yn,iss orier. of
vzaipigns, y � build6r will
6ao.' t I' i `68A'h i �!� iklo_rl`"
ri, qa ee,,_ sewage disposal system Ul (2 owing.the clate 0 f ne. issu-
ap . ...... .. . '-f teIL 0 6t:2),that, 06.`d'�ifile� W'ell -dekrIb6d
ance�.�of �the' ti n e"Or. Irs: r
prcyav�o at
�Will'tke loc as' i �thp AppK.0ye plan. e r .1 a rtiles. Y!atiqlls the'-,. Puthair .
#t6d' s own on
_an.
oun y'Depj
o-
S i g �Iid -R.A.
bate E . 1�
J al Septic Tank ff
p
Addl�
t en,�gu
of d
Construc
ihd that
:4 'Liciensel:No.,_`Z�
'the uc on he., ng s
R pne,,yeov. t �u lid i ha,,.beeri 6 ride
v
E6461�:66��T. I is, itak6n-ind is
pprovapxpires
eyopawp,, y A amp _.Meh'considered - ec!ssark-, n' m ii,tl of,446 nly cha a qr, ,qI,t,eFa.fio,n 61, construction,
qquirp- s,a.Fevi'permi .,r -A pprov- ' ed. , o' - r - dis '
p' o') sa I o .i W
�
em _75�a Ii
j_ er- sS, y : p 1 y_ -on y.
. .
171 2.1 T -T�it I
cm
Date
F I M D C I - TEC, K * LIST
Date.:
Insp.by:l
%4
INITIAL SITE ITTSPE CTION (Yes No I Comments
Property lines or corners found.. . . .
Can estimate house location * ' . 0 0 * 0 0 * *
Will driveway need cut 0 0 a. . 0 0 0 0
Must trees be repqved-note tMse . . . . . . .
Is deep hole repiesentative of entire SDS area
Additional deep holes needed. . . . . ... . . .
Sufficient SDS area available considering
..driveway cut.,house locationseparation
distances., etc . . . . . . . . . . . . . . .
DEEP HOLE DATA
Depth:
Water elevation:
Rock elevation:
Soils description:
Date:
FINAL SITE INSPECTION Ins p._ by:
House located where shown on approved plan.
ST?3 I nc,?,ted i-Th PP ,-ere a rov,'
-7
I-- f -1 211, r r P f F! 4 0.*! '1 -TIH
Width of trench average-
Slope of tile line and trench acceptable
Room allowed for expansion trenches.
..Over 50 -ft--: from :.swa-mli�i-.�,Ta-tt--rc.o.u-r-se
or' ' S area
so i
unnecessarily graded . . . . '. 0 . 0 o o a 0
.10 It. maintained from prop.line and
20 ft. from house A 0
Separation of trench from house,-, -well
etc. follows plan . 0 o 0 0. 0 0 a 0 Q
Number of bedrooms checks .
Stones., brush., stumps, rubble, etc.. &eater
than 15 ft. from nearest trench a . 0
15 Ft. of peripheral soil horizontally from,
trench . . . . . o a . ol 0 0 .0 0 0 a
Junction boxes prope-ly set
Could surface run off from driveway,. roads,
g and surface, etc. channel near SDS,
ro7
area o 0 o .. 0 o 0
Does lot drainage appear O.K. in area of SDS
FINAL GRADING OF SITE ACCEPTABLE
T- I
P COUMTY: DEPARTMENT OF B ALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
Date
Re: Property of
Located at
Section Block 91 Lot
Gentlemen:
This letter is to authorize oS ' C54 �/� ✓o��
a duly licensed professional engineer or registered architect
(Indicate-
to apply for a Construction Permit for a separate sewerage system; to
serve the above noted property in accordance with the standards, rules
or regulations as promulgated by the Commissioner of the Putnam County
J., pa.1 mein l oL n11ctiiUL - i , and to sign £iii necessary papers on my behalI In
connection with this matter and to supervise the construction of said
system or systems in conformity with the provisions of Article 145 or
tary Code.
Very truly yours,
14! !!77l1 Si
C �
° • �4 L s
°* s
P.E
s r o 0
(Seal)
Aaarew °0.240
0
A ....
SO
ecru 1, /vs
.Aasb
/yli5�- 46 -75 2 ? 2
Telephone
ress
e ep one
Pert�
vp.E'P.�,r
r .
'.
PUTNAM COUNTY DEPARTMENT.OF HEALTH
DIVISION OF ENVIRONMENTAL HEAL`T'H SERVICES
2
3
4
5
Notes: 1) Tuts to be repeated at same depth until approximately equal soil
rates are obtained at each percolation test hole. A11 data to be submitted
for review.
2) Depth measurements to be made from top of hole.
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
DESIGN
DATA SHEET - SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owne r1 V&z i�iw � T. ✓C-ii3 C,' >LE
Address ,�'F1? � �!J fiyAe�i l�i9GLEri'
Located at ( Street Sec . Z I Block Lot
�Indicate neares cross street)
Municipality /�c� �� ��i�Y
Watershed
SOIL PERCOLATION TEST DATA
REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number
CLOCK TIME
PERCOLATION PERCOLATION
Run Elapse
No. Time
Start -Stop Min.
Depth to Water Water Level
From Ground Surface in Inches Soil Rate
Start Stop Drop in Min. /in drop
Inches Inches Inches
A91
2
3: SS 4;'3 /
2r� Z3
3
4
5
2
3: SJ gt:27 3
2� 3 / Z-
3
'Z% 6''05 3c®
Z'-
4
5
1
2
3
4
5
Notes: 1) Tuts to be repeated at same depth until approximately equal soil
rates are obtained at each percolation test hole. A11 data to be submitted
for review.
2) Depth measurements to be made from top of hole.
TEST PIT DATA REQUIRED TO BE- SUBMITTED WITH :APPLICATION
DESCRIPTION -O - �SOIL-S7i NGObTlElIERE -D IV!tTEST;'. H —ES-
DEPTH HOLE N0. HOLE NO. HOLE NO.
G. L.
6"
12':• P
18"
24"
30"
3611
42"
`t8"
5411
60"
66"
7211
781
8411
_rDICATE -;LEVEL- AT ; Tr7I�ICH GROUND., WATER _--3
INDICATE LEVEL TO WHICH WATER LEVEL RISES 'AFTER BEING ENCOUNTERED' =OM �� r
TESTS MADE BY Date //- 20 -7Z_
DESIGN
Soil 'Rate Used /2 Min/1 "Drop:.: S.D. Usable Area Provideda p p
No. of Bedrooms. -¢ Septic Tank Ca
paeity /� coo Gals. Type
Absorption Area Provided By dL.F.x24" 36" ,ff, width Trent .
G v 2 ?- > > N ,o.�i �u w�� "G/��id v>✓Q ,oe ''
aa, ' Other
.� °. . ;9i,
l
Address
/
y
Z �
•a _
to °
. �`�• .
��� °•°
0
°. 24896
°�v`�•°
THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
11 "10"Ess!0 A .
Soil Rate Approved Sq. Ft /Gal. Checked by'"411'110 Date
I r
�•gYryS �� ``yy
' ee .. ■T,■ yg�� /q. y{(�Iry�., p��/qy 'AVT Ip_� p ^� �I1r�/,gp��pyn�
41 _177
�� 1,1M: -OU1 TY 1V'E AR Y.1 E \� ,S®,� LL�Nl1.J1 JlIl , .
u. 1
t Division• .of Environmental Health Services, Carmel, .N Y.'
1.0512 _
�aR A6,11 .. •.... ...� +.r. -•
"'• r�ifigff�IC fI:"6>r 81VST'0;7/r �bf�Gb PLiA13CE ,3SEWAGE �DISPOSAL..SYSTEI1fV
TO
Located at'-- Sectionm _ Bloekw
n r illage
Owner':' Lot Jobe
[/ Pow O g7... / a'?
Separate Sewerage System Dwlt by Address
Consisting•- o�Ga1SepLc'T nk 6r lineal F�e¢et X " �_ width trench Ai
Other requirements
s
Water Supply: Up. IC # ;Supply From
�FPrrvate Supply Drilled `By
Address
.w
Building TYPe.. °" ��.9 'r' G°9 V_7 A9'6 — 4No of Bedrooms Date Kermit Issued
Has Eroswn Control Been Completed e6 °t'rFr6ly c ♦PP °
e4a < �
1 certify that the system,(s) as listetl servuig' the above premises were constructed essentially as "s��rw`ii� oR > f� as�f tr�e�ompleted work (copies,of which are
-' " '`" o: :P.ut m, C*Ounty,:.Departmentof Wealth. 3
attached) and in accordance with the standards, rules and regulations plans Bled, grid °Elie �ermj c etl "by e
�.
• kw re , ied by " P E
Address : e o License No
t
Any person occupying < premises served by -the above systems) shall promptly take such actioTserr$y rp4�(de e�lire the correction of .eny unsanitary
conditions, resulting from such usage ;:Approval .of the separate sewerage system shall•becofPr� r)gygidnds. as a public Sanitary sewer ?becomes 1
r .. available and the approval of the- private water'supply shall become null and void when a publiG7- vailable.� 'Such` appYovals are
a mesa
p'- •subject to modification, or .change when m the audgment of the •Commisswner of Health; such ti's fq[6ehg tl�fication'or change is nenCessary :..
y 1 "Date BYr�'"v J TitleIr� `
al
4
ESTABLISH ELEVATION OF HOUSE TO PROVIDE DRAINAGE O.F LOWEST FIXTURE
TO SEPTIC TANK AND FIELDS ...... AREA RESERVED FO SEWAGE DISPOSAL
SYSTEM TO REMAIN UNDISTURBED. ALL CONSTRUCTION TO �ONFORM TO STATE
AND LOCAL STANDARDS AND REGULATIONS .. .. .. .
V
15 �.e YH P►'M�1 P4�� e �'
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t' 1 1 tf I AA ,2'' r lJ �pRtiw.e.ft
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TES
69 P/"E' t/_° 9;: /_oT. %° 7
PROPOSED
>tt-LG /t/A��`ijq•?�C� �' %. ✓.S.
1. /G. ti� "4d95
SEPARATE SEWAGE DISPOSAL }�• SYSTEM
/_�
k /L l_ /F+/� 7 97 F
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"DEC 11 2
a e
3 ,`; '�ICQf`
TOWN OF M 1/�LL:'}/
_...
COUNTY• NEW.YORK
pUTN. F HEAl.1N
9Y, -�'b:
10
DATE /�- / 7Z SCALE /,'S 3f /Ur•/ JO,p NO.7Z -//
SOIL PERCOLATION RATE ......../ ..MIN IN
/20o -
GALLON SEPTIC TANKy
0 , f)IVISION OF
RAM14j�it:T(TAI. HEALTH MV148i
,qn_..
:y,�- Y,..,, ,. .:• ;.
e
SULLIVAN - THIEDC.."
DEEP TEST .. C�,C�OII / ✓O yf/i7T�,P_ 9TG' -o"
3O8 LF X;�-_ ABS. TRENCHS
. 'SVI'� ,
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CONSULTING ENGINEERS
LOGE eo C,C
CLARK PLACE MATWPAC. NEG YORK
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SE=AT I "H RW
DAVID 4 JANICE WHITE
21 JEANNE DRIVE o �
PUTNAM VALLEY, NY 1057Q 5/2/06
T O
ROGER W.HOFFMANN ,.I
'AH:.MEf TE-.4
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