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631- 589 -8100
73.20-1-16
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03491
SHERLITA AMLER, MD, MS, FAAP
�pp Commissioner of Health)y�
4 - i -•- K.Y. -YCsG' vas- '� >F'st'd�.1 tiY :• G�= 'i•.^e a� .: .'ler!
LOIcETTA MOLINARI, RN, MSN
Associate Commissioner of Health
August 5, 2005
Carlos Reis
38 Partridge Lane
Putnam Valley,' NY 10579
Dear Mr. Reis:
ROBERT J. BONDI
County Executive
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DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Re: Addition — Approval - Reis
No Increase in Number of Bedrooms
38 Partridge Lane
(T) Putnam Valley, T.M. 73.20 -1 =16
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 the Department dated August 5, 2005. 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.
i3. _: f;l i polmnhinv T xni c; rr ;;f, �t 'undare i w•4b wattr.savin� dev ce; '(i.e:.a- low iu511
toilets, restrictors for shower heads and faucets etc.).
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.
Very truly yours,
oseph S. Paravati Jr.
Assistant Public Health Engineer
JSP:cw
cc: Building Inspector, (T) Putnam Valley
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
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
01
LORETTA MOLINARI R.N., M.S.N.
Public Health Director Associate Public Health Director
Director of Patient Services
DEPARTMENT OF ]HEALTH
I Geneva Road
Brewster, New York 10509 D
Environmental Health .(845)278,6130 Fax (845) 278 - 7921
Nursing Services (845) 278'- 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845) 278 - 6014 Preschool (845) 279-6082 Fix (845) 278 - 6648
I
ADDITION APPLICATION (RESIDENTIAL ONL)O
STREET � ffigmr)ke t4ke TOwN_AEom �ftxma# -73.
NAE JOA0 C 0 R/W RIF f PHONEO�o 1-12
CHD POW
MAILING ADDRESS AB fAkaakDU-e C PLYWAR t kLt 1 00'ri-l-'Of
.n-E'SCkTT1ON OF ADDitiO.N'. d STo> bk"A I-Kimem 2� Qbld- N-Jorau/
iNb-.,%,ME.R.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 Engined or Registered Architect in accordance with applicable sections of the
Putnam County S4#yy.Code..
Please submit this form. and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY
10509,.Phone 278-6130.
2. Sketches. ofe-ZRij., 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 acceotabld.
4
5.
.
OFFICE USE
Comments
Feb98
BFhouseguidelines
LORETTA MOLINARI
Public Health Director
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 10509
Environniental Health (845)278-6130 Fax(845)278-7921 .
Nursing Services (845)278-6558 WIC (845)278-6678 Fax(845)278-6085
Early Intervention/Preschool (W)278-6014 Fax(845)278-6648
Putnam County Dept. of Health
1 Geneva Road,
Brewster, NY 10509
Re:_ ge i's
Residence
ROBERT J. BONDI
County Executive
Zoo 1,
Tax Map 2LL0_-
Town
To Whom It May Concern:
According to records main ed by the Town, the above noted dwelling,
IS NOT
In compliance with Town code and the total number of bedrooms on record is �3
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
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I JUN, 22, 2005 ') : 16PM LAWLESS & MANGIONE NO. 7818 P, I
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AAMITECTS 4" FNGfNMS,_.
(914) 423-8844 (21J) 475-0970
PAX (9.14) 423-8981
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To,
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From: wle%
Pages to follow (including this covet,,.
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SHERLITA AMLER, MD, MS, FAAP al ROBERT 1 BONDI
Commissioner of Health *, } County'Executive
LORETTA MOLINARI, RN, MSNL �C►� �OQt
Associate Commissioner ofHealth
DEPARTMENT OF HEALTH '.
1 Geneva Road, Brewster, New York 10509
June 21, 2005
Joao Carlos Reis
38 Partridge Lane
Putnam Valley,.NY 10579
Dear Mr. and Mrs. Ruggiero:
Re: Addition — Reis
38 Partridge Lane
(T) Putnam Valley, T.M. #73.20 -1 -16
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. 'The legal bedroom count for the dwelling is three. The potential bedroom count of your
proposed addition is five.
2. The addition of a potential .bedroom(s) 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 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.
Si ere'ly,
oseph S. Paravati Jr.
Assistant Public Health Engineer
JP:cw
Cc: Building Inspector, Putnam Valley
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
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
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Notes • '. '
.1) Tests to be repeated at same depth until approximately equal soil rates are ob-
tained at each percolation test hole. All data to be submitted for review. -
2) Depth measurements to be made from top of hole.'
PUTNAM COUNTY DEPARTMENT.OF HEALTH .
DTVTSTON OF ENVIRONMENTAL HEALTH, SERVICES
rra.,..i. ..ca .y: .pY . A`i^r..rrisaT$! 1$:1�.�s..:yr..*m.:_ _ r, e- iA.;�.�.�i- .�.�yi::� ?aep,)i�: 9.':4�i�vYti.w:c :r.t��— ..e-{ :p .�i:7Fe �• waEfruir:u•.:vwK:...,ii.. .r •}�� ?. ,(�:•,�..�.. aia':s.�
DESIGN 'DATA SHEET ,- SEPARATE SEWAGE DISPOSAL .SYSTEM . FILE NO.
Owner s�'vTiy/a/�lC,eE.S'
, ��C
AddressA,E.� SST, :.. /'GT.Viri.de -CG-Y; /✓.}�
Loc ated at (Street)_,�T2ipG�`•
. Sec ._PC -9 Block oddSLot ¢2
(Indicate. nearest
cross .street)'
:,Municipality ,
y�.
SOIL PERCOLATION :TEST .DATA' REQUIRED
.TO' BE `SUBMITTED WITH. APPLICATION'. ._ ;,
Hole
Number CLOCK TIME
:PERCOLATION :. PERCOLATION'
Run
..Elapse
Depth to Water Water-Level. "
No:
Time:- . ..
From Ground Surface -in Inches Soil Rat( `:
.Start,.
Stop.. Mina
Start' Stop. Drop in :Min/in: drop
Inches Inches Inches,:.:
l .3 ,'�.,�.:.
wZ� /.�''�
`� / �' °� ;% /mil iA✓/ s.
4
//°
2
0_a6 45
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Notes • '. '
.1) Tests to be repeated at same depth until approximately equal soil rates are ob-
tained at each percolation test hole. All data to be submitted for review. -
2) Depth measurements to be made from top of hole.'
T- �V.TI.M ..,•q.Z ai�`;•.._,�:...p _ ., t•�j�,.3T ._. � T aT•1„�.. "' .. n., ._� .,.. _."-.. Y; av4••���eagc+�.l'�T ^r :�v..f.�.
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DESCRIPTION OF SOILS ENCOUNTERED.IN TEST HOLES
.
-2-41f
3 0Tt ti N
36
tt �i
42 ttEAiJ'.fa.� -1.
48 rt ,� ,6oCA�
.0 fX7
5 4t'
60"
66tr.
7Ztt. _.
78 rt
8 Ott
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED .
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY �, �N�/' �' �°��� �• Date /!9
DESIGN
Soil Rate Used dO Min/1-7 Drop: S.D..Usable Area Provided :5'0,00 No. of Bedrooms Septic. Tank Capacity t2e o Gals. Type, Co-A✓C
Absorption Area Provided By L.F.x24't 36" ,/width trench. Other
-7-A AC iA/Sir M z I- �� Ad? ._{�lnL9LSA! 'O7lf �G.�/✓
Name
Address,
t Signature
c
SEAL
PUTNAM COUNTY DEPARTMENT OF HEALTH
Soil Rate Approved 'Sq. Ft. /Gal.
Checked by_
H
H
h
• N
3 0Tt ti N
36
tt �i
42 ttEAiJ'.fa.� -1.
48 rt ,� ,6oCA�
.0 fX7
5 4t'
60"
66tr.
7Ztt. _.
78 rt
8 Ott
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED .
INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY �, �N�/' �' �°��� �• Date /!9
DESIGN
Soil Rate Used dO Min/1-7 Drop: S.D..Usable Area Provided :5'0,00 No. of Bedrooms Septic. Tank Capacity t2e o Gals. Type, Co-A✓C
Absorption Area Provided By L.F.x24't 36" ,/width trench. Other
-7-A AC iA/Sir M z I- �� Ad? ._{�lnL9LSA! 'O7lf �G.�/✓
Name
Address,
t Signature
c
SEAL
PUTNAM COUNTY DEPARTMENT OF HEALTH
Soil Rate Approved 'Sq. Ft. /Gal.
Checked by_
G e n t 1 e rl� :11 :
D I" I S 0 OF E`i' 7ir 7--DO L T
Re: Propel-ty 0_ 7-W,41" 1-7Cf16,S0 jAIC--
Locauea EL U
'�on .90 T ot /2
SecL.. B1. o c 06'qo 4o— J_.)
This lett-er IS to au'-
a, duiv, licenS ed ol'
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'LL7, Edu--az',-_on La%;-, I and the Co--inty San--
tary Code.
Very t- lnul v. yours
Countersi cm,=
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r e s s
Z% np
Signed
Address
C
�j / Town or V9i1a9e
Located a •`, .C. Q%►7L' U /ice �v� �4Il Section P.c' ^'9 iYf' G� 9G? Block' i
OwnerCl /I?Diya Lot
Job
Separate Sewerage System built by ® � 01M Address 0/��1
Consisting of �!�• Gal. Septic-Tank lineal Feet X �� wid'
Other requirements.
Water Supply: Public'
ublic`Supply from
Private Supply .Drilled BY //lfr
Address. order- 3f P411i74,w I'y Ile
p�
Building TYPe J el No: -of Bedrooms Date Permit Issued
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Has "Erosion Control Been Completed �
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I „certify that. the.system(s), as listed serving the above•premises were constructed' ,essentially as shown on'the -plans of the completed work (copie i6 0
attached), and in accordance .with the standards, rules and regulations, plans flied .and the permit issued by the . Putnam County Departm�
Dafe Certified by P.E.
26,.7Q floc!. ./?%i/ iCVP� i►/” /sr.�f c%�T /2 r
Address License 'No.
Any person occupying premises served by the above system(s), shall promptly :take such action as may,be,;necessary to secure.the correction of a, ;yy
conditions resulting from such usage Approval .of'the separate sewerage system shall. become null 'and void.ai soon as a public sanitary, si ai
available and the approval.of the private water supply shall .become null and '.Void when a public water supply becomes available $uch.j ss
sub)ecY to+ modification or change when, iri the .Judgment-v the ,Commissioner of 'Health, such revocation, modification or change ii
r ,
Date By Title.,
:�t once •
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PUTNAM COUNTY rDEPARTMENT OF IEAL,TI F
Did/s/on of 'Environments /'•,Hea %tti• Services Carme% N "Y 10512
vTiLiv'�.unu"'L.1�':9yC r3fi�.JGWb�f I�IS �S�tYS SYEflfl
�j / Town or V9i1a9e
Located a •`, .C. Q%►7L' U /ice �v� �4Il Section P.c' ^'9 iYf' G� 9G? Block' i
OwnerCl /I?Diya Lot
Job
Separate Sewerage System built by ® � 01M Address 0/��1
Consisting of �!�• Gal. Septic-Tank lineal Feet X �� wid'
Other requirements.
Water Supply: Public'
ublic`Supply from
Private Supply .Drilled BY //lfr
Address. order- 3f P411i74,w I'y Ile
p�
Building TYPe J el No: -of Bedrooms Date Permit Issued
j-CS
"
J
Has "Erosion Control Been Completed �
44:-
e a ofW
I „certify that. the.system(s), as listed serving the above•premises were constructed' ,essentially as shown on'the -plans of the completed work (copie i6 0
attached), and in accordance .with the standards, rules and regulations, plans flied .and the permit issued by the . Putnam County Departm�
Dafe Certified by P.E.
26,.7Q floc!. ./?%i/ iCVP� i►/” /sr.�f c%�T /2 r
Address License 'No.
Any person occupying premises served by the above system(s), shall promptly :take such action as may,be,;necessary to secure.the correction of a, ;yy
conditions resulting from such usage Approval .of'the separate sewerage system shall. become null 'and void.ai soon as a public sanitary, si ai
available and the approval.of the private water supply shall .become null and '.Void when a public water supply becomes available $uch.j ss
sub)ecY to+ modification or change when, iri the .Judgment-v the ,Commissioner of 'Health, such revocation, modification or change ii
r ,
Date By Title.,
:�t once •
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PEEKSKILL CAL MEDI LABORATORY z
} 1879 Crompond �Rd Maple Terrace B1dgL A 27954
v4 Peekskill, New York _� 4
p PE 7-8771
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(,.+� -,.s 4 ..v,.. .t.f,!?...'^'�.I. '� ,. ..y u:; �. .. ::s ~'Y•- A.$f'^�•s+tr ys +�4_ 'n" .c.Vt AF•: :,v�ib t,�S.,r -yaarl ..•+,- .�w..��c -..trp .+p.
... .. ..' .. ,..�_:� — - a�� u^a' -4�• yam,
RESULTS�OF EXAMINATION OF WATER 41 `�l� Dr",TE COLLECTED
s .. r/
'OWNER r t
DATE RECEIVED
ANDERSON ELL', DRILLER
51'
5 .72
:CITY VILLAGE TOWN O®r -MAME OF SiJPPLY .
j a j DATE REPORTED _
WELLS F
a .a,
BACTERIA:'PER MLr (Agar!plate4count at 35° ) COLIFORM GROUP (M stprobablerNo'' /IOOmI j 3 RESIDUAL' CH'LORIN'E :AS•RECORDED AT
'SAMPLING POINT POINT':OF'TREATMENT
RCYf'H TFSG TNpN 2� ?�' vas I t
CHLORIDES CI m 1
'NITRATES (as
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FLOaURIDE {F) mg, /1
n.; -�a;. c -n.; ..'.." s �; ,v ':'� _.' L �..:3� 4x;. �''- 1�'rt �n 1 s•,u� '���"'�° �, a .�` 1a.'. ,;,. , :.` ,1
These results mdicaie that .the water was : ES of: a satisfactory sanitary quahtywhenhthesampletwas collected ;'• �B�. ;' 4Z °2 5 •y 'i
�.v.: .. ° °F :ti' R 5 4a �..'. ',� '£, �+',� .7,�,y 6 aao �i't/Wt�.' ^r �� i.�.u.��•.
PA;DOVANI M
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WELL COMPLETION REPORT
3/71
LJ
PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental Health Services
COUNTY OFFICE. BUILDING - CARMEL, NEW YORK
_a' 2._ .I?ia. -��L� c sj;;J;� ; ?E" rl�? 1y� -b� f !:)F.i: �� S,JIJrt�7 _$fla' CC!•lyi.' i'Qul�li s fTf1F `21 ^ftl` lltFel. fg,,r1'• r ,�.p,
analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued.
REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION
OWNER
X(Lot
LOCATION
OF W ELL
(No. & reat)
own)
Number)
PROPOSED
USE OF
WELL
®. DOMESTIC
❑ SUPP Y
BUSINESS
❑ E TABL SHMENT
E]
❑ FARM
AIR ❑ AIR
CONDITIONING
❑ TEST WELL
❑ OTHER
(Specify).
DRILLING
EQUIPMENT
❑ ROTARY
�A R PERCUSSION
❑ PERCUSSION
OTHER
)
CASING
DETAILS
LENGTH (feet
oZ.6
DIAMETER(Inches)
��
WEIGHT PER FOOT
THREADED ❑WELDED
DRIVE SHOE
AYES ❑ NO
S CASING
YES
j 7
LJ NO
TI EST
❑ BAILED
❑ PUMPED ® COMPRESSED AIR HOURSy
�%
G.P.M.
YIELD (t3.P.M.)
WATER
LEVEL
MEASURE FROM LAND SURFACE —STATIC (Specllyfeet)
DURING YIELD TEST [feet)
Depth of Completed Well
in feet below Land surface: 7D
SCREEN
MAKE
LENGTH OPEN TO AQUIFER (toot)
DETAILS
SLOT SIZE
DIAMETER (inches)
IF GRAVEL
PACKED:
I Diameter of well including
gravel pack (Inches):
GRAVEL SIZE (Inches) FROM (feet)
TO (feet)
DEPTH FROM LAND SURFACE
FORMATION DESCRIPTION
Sketch exact location of well with distances, to at least
two permanent landmarks.
FEET to FEET
l
�
/0'
:
a"
%
/6'f
/70t
If yield
was tested at different depths during drilling, list below
FEET
GALLONS PER MINUTE
DATE WELL C MPLETE
' DATE OF REPORT
WELL CY ER (Sign ure)
e .
..o
a
wner or Furchaser o
Building Constructed by
L
Location - Street
J
Building Type '
cip
Section
Block
Lot
GUARANTY OF SEPARATE SEWAGE-SYSTEM
I represent that I am wholly and completely responsible for the
location, workmanship, material, construction and drainage of the sewage
disposal system serving the above described property, and that it has been
constructed as shown on the approved plan or approved amendment thereto,
and in accordance with the standards, rules and regulations of the Putnam
County Department of Health, and hereby guaranty to the owner, his succes-
sors, heirs or, assigns, to place in good operating condition any part of
said system constructed by me which fails to operate for a period of two
years immediately following the date of- initial use of the sewage disposal
system, or any repairs made by me to such system, except where the failure
to operate properly is caused by the willful or negligent act of the occu-
pant of the building utilizing the system.
The undersigned further agrees to accept as conclusive the de-
termination of the Director of the Division of Environmental Health Ser-
... _.... -._ vices• -,of - tb;e: - �?�tnarr:- C- ou�ty- pepartment of - Health as:tQ•.whewt�er:or not.:. -t e - -
fai'lure' o' system to operate' was caused .by� the' will or negli sent
act of the occupant of the ilding utilizing the syLZ .
Dated this �.� day of 19 Signature
Title ? --
lir corporation, give name
ad re s s�y
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE
CERTIFICATE OF COMP±TETION WILL BE ISSUED.
GUARANTOR IS REQUIRED TO FILE NOTICE, OF DATE OF FIRST USE OF SYSTEM.
Division of Environmental Health Services, Putnam County Department of Health
I N,t,t r ,
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$0 6 0 ! h
r` ARROWS �O-pPERATIVE J WA
THREE HOt
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