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631- 589 -8100
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PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
4
Ct WZY A IM'FQDnQ A.1r
OFFICIAL USE ONLY
0
SITE-'LOCATIW -7 Q j' ,,l a TM# :3
OWNER'S '.' NAME,
650
MAILING -ADDRESS'O'
fOr
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PERSON INTERVIEWED A:f:f PCFID Complaint #
Naine & Kelationstup ki.e., ownef, tenant, etc.)
DATE TYPE FACILITY A
PS
AD
.Prdb6§al. (include, sketch locating all adjacent wells):
k411-10 "I
NOTE: in same location and of same type as original sewage disposal system Different location
I -'t . "�
may i& 'qdireisubmittal of proposal from licensed professional engineer or registered architect.
o"
as.
y r A" y L .1y 4 e- d 914
1
2
b.
'c.
d.
►rted agent of owner agreeAt64he conditions. stated on this form.
,0 --r-f h--f TITLE ]DATE
wea wim me ionowing conamons:
,meht of any Town permit, if applicable.
sion of as built repair sketch in duplicate showing:
,Owner's name
Site Street Name, Town and Tax Map number.
Location of installed components tied to two fixed points (e.g.,house comers).
System description (e.g., 1250 gal. Concrete septic tank, three precast 6'diam. -X 6' deep
Installers' name and number.
.repAirto be performed in accordance with the above proposal and conditions.
u,
Inpector's Signature & Title
4i,
COPIES:
White (PCHD); Yellow (Town BI); Pink (applicant)
iRF� 99MLIk-,'i
�v
a.,
.V
BRUCE R. FOLEY
Pu5.1ir. Heeith direct
DEPARTMENT OF HEALTH
1 Geneva Road
t
Brewster, New. York 10509
LORETTA MOLINARI RN., M.S.N.
ra ;oc aCe Pu�iir' il--al:h .frecror -
Director of Patient Services
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) 278 -6082 Fax (845) 278 - 6648
Joel Greenberg R.A.
2 Muscoot North
Mahopac NY
Dear Mr. Greenberg:
September 1, 2000
Re: Addition- Pfister - 7 Laino Place
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 75.15 -2 -23
I have received and reviewed the plans for the proposed addition of the above - mentioned
residence. The proposal for the addition has been approved as per plans bearing the approval
stamp form this Department dated S ptember 1, 2000 The addition is approved with the
following conditions:
1. The total number of bedrooms must remain at ou without prior approval by
this department.
2. The area of the existing sewage disposal system, and its expansion area, must be
maintained...
All plumbing+ fixtures must be updated with water saving devices, i.e., new low
flush toilets, restrictors for shower heads and faucets, etc.
4. The septic system must be expanded as shown on plans prepared by Joel Greenberg RA
dated 9/1/00 R 219 -00.
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,
William Hedges
WH:kg Senior Public Health Sanitarian
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JOEL L. (5REENSER(5
DRAWING TITLE:
—tOPITIOW -MIAMS-At
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A R G H I T E G T
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2 MJSCOOT ROAD NORTH
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MHOPAC, NEW YORK 10541
(414) 62"613
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WILLIAM & BETTY PFISTER WELL
LOT1.181Y
JOEL L. (7REENBER(7
. I ARCH[TECT
2 MY%OOT ROAD, NORTH
MAHOPAC, WA YORK 10541
(414) 626 -015
FAX M14) 626 -2601
17RMINS TITLE:
ADp IT I OW 10 49SIDS FDR
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JOEL L. GREENBER6
A R C, H I T E r, T
2 Mr- c= ROAD NOPM
MAHOPA-C, MM YOW, 105M
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FAX MQ 62S-2W
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JOEL L. C REENBER
A R 6 H I T E C T
2 MJSCOOT ROAD NORTH
MAWrAC, HEM YORK fOM
FAX M4) 62b-UM
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D"tO TITLE:
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7- 0&-113
9/7/06
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C PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
..........
OP
-Jj OFFICIAL USE ONLY
SITE LOCATION -7 _TM#_
OWNER'S NAME
MAILING ADDRESS .4 01
PERSON INTERVIEWED PCHD Complaint#
—Name Kelationslup (i.e., owner, tenant-, etc.)
WNW ,
PROPOSED
/_\170).11 -1
TYPE FACILITY 6' -f S. V - 19qll, Z,,,
PHONE.
REGISTRATION#
Proposal (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original sewage disposal system Different location
may require submittal of proposal from licensed professional engineer or registered architect.
I, -as owner, or. reported agent of.owner afir tdV.7 nditions -stated -on thisfiorm.
DATE_
F 4—L
Proposal approved with the following conditions:
I Procurement of any Town permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name
b. Site Street Name, Town'and Tax Map number.
C. Location of installed components tied to two fixed points (e.g.,house comers).
d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6'diam. X 6' deep
e. Installers' name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
Proposal approved_='
Inspector's Signature & Title
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
PC-RP 99NE
T E
P
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CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE TREATMENT SYSTEM
PCHD CONSTRUCTION PERMIT # _ ='�� 5` V—ce J h � � �' 1 ��
Located at 7 L A j }fit z) E P, t, A eL-
Town or Village
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Owner /Applicant Name \V � el!5 TF= E
Tax Ma , jJ
Block
Lot
Formerly t� A Subdivision Name ! DTs !2
Subd. Lot #
Mailing Address LAINQ LAIN PLACE, . LL Ie - Zip 0."-;
Date Construction Permit Issued by PCHD
9/!2 `2 0 0
-7 L,A W Z:� L, r
Separate Sewerage Sysge�n built by ��/j jet` p:_ Address �C17,� m A 1.
Consisting of t Gallon Septic Tank and Su 6 L, i✓ ( - 1 -k1s�r. $
Other Requirements:
Water Suganly: Public Supply From Address
or: Private Supply Drilled by EXIST'/ N 6 Address
Building ype - ! D' Has erosion control been
Number of Bedrooms 15
Has garbage grinder been installed? C�
I certify that the system(s), as listed, serving the above premises were constructed essentially as shown on the as-
built plans (copies of which are attached), in accordancpwith the issued PCHD Construction Permit and approved
plans and the standards, rules and re u ons of the
Date: '-; L12 Certified by
Address I Ax a v e o b
County epartment of Health.
%4&yr� P.E. R.A.
mJ y�,
� License # 11056
Any person occupying premises served by the above system(s) shall promptly take such action as may be necessary
to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewage
treatment system shall become null and void as soon as a public sanitary sewer becomes available and the approval
of the private water supply shall become null and void when a public water supply becomes available. Such
approvals are subject to modification or change when, in the judgment of the Public Health Director, such
revocation, modification or change is necessary.
B Title•
Date:
White copy - HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Design Professional
Form CC -97
01.
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WILLIAM & BETTY PFISTER
WELL
LOT. Yl B
-41
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34
34
5T40140
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WILLIAM & BETTY PFISTER
WELL
LOT. Yl B
-41
Mil-Cm of HeWth
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JOEL L. 6REENBER( .7.
ORMIM TITLE:
I T1 ow 10 eAV5 FOR
NEVISION5:
DATE,
81
/28/Do
PROJECT NOt
7 -OQ- 1a
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R 6 H I T E C. T
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2 Mss= ROAD- NORTH
• I-AIWO PLACe,
-
SCALE
DMONT By:
MAHMAC, NM YORK 10541
FU -r- V& LL F- Y., N /0
(414) 62b-60
PAX (MA) Vkso-2W
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PUTN iM COUNTY Y DEPT SRTMENT OF HEALTH
DIVISI ®N OF ENVIRONMEN'T'AL HEALTH SERVICES
.._ -. _.. -... _..- -. ...__.._...- -.
GUARANTEE : sr .r®�. F SUBSURFACE . „S- E eV... ; A' G..._E TR.. � E A T...M.. E.- N caT m �': -.n -w sr►
SYSTEM.
I "_� �
Building Type
76.15 2 25
Tax Map Block Lot
_P1JTM,qt,A VALLEY
Tow
*PFis- r
Subdivision Name
Subdivision Lot #
I represent that 1 am wholly and completely responsible for the location, workmanship, material,
construction and drainage of the sewage treatment system serving the above - described property, and
that is 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 guarantee to the owner, his successors, 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 approval of the "Certificate of Construction Compliance" for the
sewage treatment 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 occupant of the building utilizing the
system
.ry.. - -
The undersigned further agrees to accept as conclusive the determination of the Public Health
Director of the Putnam County Department of Health as to whether or not the failure of the system
to operate was caused by the willful or negligent act of the occupant of the building utilizing the
system.
Dated: *o #th Day IR Year Signature:
Title: Z..
- Signature
Corporation Name (if corporation)
Address: 7LQ I W cp y
Corporation Name (if corporation)
Address:
State N.Y. Zip 105 State Zip
Form GS -97
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAID.
OFFICIAL USE ONLY
;2, /C7 --(r"7-0
SITE LOCATION :Z dam% TM# -7.5-- -'.a -- 2
OWNER'S NAME. �°� ::.s it �ii� PHONE
MAILING ADDRESS y7 L 401
PERSON INTERVIEWED PCHD Complaint #
ame & Relationship i.e., own , tenant, etc.
DATE TYPE FACILITY P/1,9 If
PROPOSED IN
ADDRESS
PHONE
REGISTRATION#
Proposal (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original sewage disposal system .Different location
may require s°,u(bmittal of proposal from licensed professional engineer or registered architect. L
O'd e/ ioyr , / /e ' .q' �-rJL- per' A - ®C 4. ej �? o�C4 15 /-G 6p
13-41
4,44 Zv
�;.as owner for. re orted agent of ovne, a e eoiiditio s`stated- this fczrrio
SIGNATURE.::j,- P/ l� TITLE Ao DATE
Proposal approved with the following conditions:
1. Procurement of any Town permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name
b. Site Street Name, Town and Tax Map number.
C. Location of installed components tied to two fixed points (e.g.,house comers).
d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep
e. Installers' name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
Proposal approved c—�_
Inspector's Signature & Title
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
PC -RP 99ML
I A
0 '-
BRUCE R. FOLEY
r-:Public-Health . Director,
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI R.N., M.S.N.
-, .Associate"puhLic:
Direetor� of Patient Services
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) 278 -6082 Fax (845) 278 - 6648
September 1, 2000
Joel Greenberg R.A.
2 Muscoot North
Mahopac NY Re: Addition- Pfister - 7 Laino Place
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 75.15 -2 -23
Dear Mr. Greenberg:
I have received and reviewed the plans for the propo a addition of the above - mentioned
residence. The proposal for the addition has been 1pyoved as per plans bearing the approval
stamp form this Department dated September 1. 20W The addition is approved with the
following conditions: �� �
1. The total number of bedro rem a our wit ut prior pproval by
this department.
2. The area of the existing s age disposal syste Its expansion area, must be
maintained.. _ __ _ .4..- _
Alf plumbing fixtures must be updated with water saving devices, i.e., new low
flush toilets, restrictors for shower heads and faucets, etc.
4. The septic system must be expanded as shown on plans prepared by Joel Greenberg RA
dated 9/1/00 R219-00.
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,
William Hedges
WH:kg Senior Public Health Sanitarian
Cc:BI
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JOEL L. 6REENBER6 E
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JOEL L. 6REENBER6 E
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JOEL L. GREENBERG
DRMN6 TITLE:
►ttMSa&
DATE: -
e /240,0
PROJWT No:
7-00113
14 azo& zs. W hk, P ms -miz,
A R G H I T E G T
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PUT ��ALLE Y, N.Y. lOSi�
„
i MAHOPAG, HEM YORK 10541
(414) 625463
PLC
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TM - 75. . I S - fi
FAX (�%) 6M-2W
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WILVA M & BETTY PFISTER WELL
LOT 8
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oo
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JOEL L. GREENBER5 ....
R C, H I T E C T
2 HJ5600T ROAD, NORTH
MAWPA-,, NEA YORK 10541
(414) M-00
PAX M14J 626-2W
ORMIN6 TITLE:
op I TI OW TO DADS FOR
�V 'pmsnq
7 LAW* f1t.&GM,
FUT. Vh LLA Y.0 N oy. /0579
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JOEL L. GREENBER5 ....
R C, H I T E C T
2 HJ5600T ROAD, NORTH
MAWPA-,, NEA YORK 10541
(414) M-00
PAX M14J 626-2W
ORMIN6 TITLE:
op I TI OW TO DADS FOR
�V 'pmsnq
7 LAW* f1t.&GM,
FUT. Vh LLA Y.0 N oy. /0579
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AUG- 29 -2000 02 :12
i
P.02
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' p.c�in� r�btia'.He01th 06ap/at
• DEPAR7ME1�'T OF HEALTH
•Ws +at,Oi fmaonMnV Health Services
R Geneva` Road, Brewst , New York 10569
t914t 8766130
1
Putnani County Dept *f H:aith
4 Geneva Road
ErmysWr.DIY 10509
jlte: WILLIAM! PPISTEIt
Residence
ifa_YMap_ 74.15 -2 -23
(f0l111 PUTNAM'"VALLEY
i
Gentleman: .
According to records maintained by the To%m% the above noted dwelling
lS
is NOT
eomgliancc .Mt>p T ®\`ti'n code and the ttal number of bedrooms on record
'this rotor ation has been obtained fror :
CERTIFtCUS OF OCCUPANCY: �/
,
ASSESSORS RECORD:
OT6-fP.R
G
n..:01r.... Tnc.,aPfP►f
TOTAL P.02
PEPAkTMENT OF HEALTH '
Dlvlslon of znvironmentmr medth 'servrees
4 Geneva Road 8/28,/2000
Brewster, New York 10509
Tit. 014) 278 - 6130 F=(914)218-7921
• pROPO_ SED ADDITION APRO ATIO�'�I OM WEbWAL ,�IzY1
PUTNAM
STREET LAINOS PLACE' TOWIN VALLEY TXMAP#i 75.15-2-23
NAML WILL'Z,AM PFISTER PH0NE528 -6638 pCHDV
MAMING ADDRESS 7- LAINOS PLACE, PUTNAM VALLEY, N. Y. 1 0579
DESCRIPTION OF ADDITION 3 BEDROOM ADDITION
h'UtNIBER Off' E3aSTBI,G AEDROO:1M5 3 ]PROPOSED k OF BEDROOM 5
(FROM CERT. OF OCCUPANCY OR —7—
CEFtTWJCAT10.%%' FROM BUILDWO W$PECTOR)
`Any addition wblch is considered a bedroom requires formal approval ofp1ans•(C6nAMct1on
ptep3tb4 -by a Professional Engineer or Registered Architect In accordance with
applicable sections of the Putnam County Sanita►y� Code. `=. :. .
Please submit this form and the following to Putnam County Health Dept., 4 Geneva Rd,,,
Brewster, NY 10502, Phone 278.6130.
I. Certified check or money order for $100.00
2. Sketches of existing floorplan (drawn to scale, all Hylug area including basement)
* Non-professional sketches are acceptable t
3. Two sets of proposed floor plan (drawn to scale; with name, street, end tax map f) ,
*'Non-professional sketches arc acceptable '
4. Copy of survey sbowing well and septic location, to the best of your knowledge. Include date
of io stallation iflwown. Label all .w ells and septic systems within 200 feet of the property line.
Contact US office with any questions.
5. Copy of Cert, of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
• �p'F10E• rI�E
Comments
_ - BRUCE R. FOLEY
Wk iPe6ttkl ,,O�vietcr'. _.- ...... ,
DEPARTMENT OF HEALTH . '
Dlvlslon of rnvlranmenmi Health • Servlcu
4 Geneva Road 8/28,/2000
Brewster, New York 10509
Tel (914) 278.6130 Fax (914) 278.7921
` P$OPOSh"D AD ITIQN�,PPLi TIN • ($F�Ii�EhtTt�►I.O� �1LY)' .
PUTNAM
STREET LAINOS PLACE TO'WI VALLEY TXMfi 75.15 -2 -23
N j$ WILL'Z.AM PFIsTER px(jNE528 -6638 PCHDN
bWLIN(iADDRESS 7 LAINOS PLACE,PUTNAM VALLEY,N.Y. 10579
DESCRIPTION OF ADDITION 3 BEDROOM ADDITION
' I TIMBER OF E)aSTI .G BEDROOMS 3, PROPOSED 11 OF BEDROMMS 5
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM HU1LDWO INSPECTOR)
*Any addition which is considered a bedroom requires formal approval orp2etis.(Construction
'lilt ) prepared- by ft-Professional Engineer or Registered Architect In accordance with
applicable sections of the Putnam Cvturty SanitarjCode.. _ : _ i
Please submit tills form and the following to 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 floorplan (drawn to scale, all Hylog area Including basement)
Non-professional sketches are acceptable - t
3. Two sets of proposed floor plan (dra%n to scale, with name, street, end tax map #�
4 Non-professional sketches are acceptable '
4. Copy of survey showing welt end septic location, to the best of your knowledge. include ditto
of installation if !mown. Label all wells and septic systems within 200 feet of the property line.
Contact this office with any questions. �
5, Copy of Cart, of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
Comments
•••6 -•• •, •• v.,. i,�t. DU1LL117U ucr b19 *ebbbUb
AUG -29 -2000 02,12 P.1
P.02
i
�� � . -. f - .... - - ..... . , .r ' . �_ .. - . �� � � . K .. _,- �._ ...._...., u BRUCE R fOlt.l►. W.�..... � -> s .. -
Acdnv" rubt(w.Ne11th Oae;lo,
DEPARTMt'tKT OF HEALTH
• bivisiw, , 0i fmiremrnentl Health Services
4 Geneva Road, Brewstef, New York 10509
(914) 27iiJ6130
Putnatri Cdunty Dept of Health
4 Geneva Road
Bcatireter. NY 10509
'Re: WILLIAM PFISTER
Residence
TaK Map_ 74.15 -2 -23
PUTNAM" "VALLEY
Gentleman: '
According to records maintained by the T*%n% 0* above noted dwelling
+ IS NOT .
at cmrn liQ=t with Td�11 code and the t tat.number,of bedrooms 00,reeOrd
;
This infomution ho been obtained f 0q:
CERTIFICATE OF OCCUPANCY: '
ASSESSORS RECORD:
OTHER
TOTAL P.02
N
760
4AW
Abbi e
Nt u
�MJ � `` ti �w $o, ��
So
10
12
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tn -
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WILLIAM & BETTY PFISTER WELL
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JOEL L. 6REENBER(7...
A R 6 H I T E C, T
2 K60OOT ROAD, NORTH
MAHOPAC, NEW YORK 10541
M14) 62b-M19
FAX (4141620-2W
DWINS TITLE:
.ADP IT I OW 10 19SOS PDA
Me 0 MPA. \vm PFISTilp-
7 ILAIWO P•ACe,
RUT. V,& LL. F— Y., N oy, /O5 79
TM -75.15 -'2.23
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PUT VALL9 Yt N.Y. 105 »
- 75. �5 - Z 2 3
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` JOEL L. 6REENBERG
A R G H I T E G T
' ` E CC'" a Mr -coon ROAD NORTH
MAROPAL, HEM YORK 10541
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7 L o N a L O M TC
PUT. VALLEY, NY 10"0)
"rM —75.15— Z - Z 3
JOEL L. GREENSERG
ARCHITECT
( ] MUSC.00T ROAD NORM
MAHOPAG, ME" YOM IOM
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BRUCE R. FOLEY
.. ..:P:scisea[thF Direcor .... -.c r • >.
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New, York 10509
LORETTA MOLINARI R.N., M.S.N.
'4ssvci6te--f1vitc"fie"aak - -tirwto
Director of Patient Services
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) 278 -6082 Fax (845) 278 - 6648
Joel Greenberg R.A.
2 Muscoot North
Mahopac NY
Dear Mr. Greenberg:
September 1, 2000
Re: Addition- Pfister - 7 Laino Place
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 75.15 -2 -23
I have received and reviewed the plans for the propZ,its he above - mentioned
residence. The proposal for the addition has been lans bearing the approval
stamp form this Department dated 20 The addition is approved with the
following conditions:
1. The total number of bedro rem a ut prior pproval by
this department.
2. The area of the existing s� age disposal sysnsion area, must be
v _ 3. v w All plumbing fixtures must be updated with water saving devices, i.e., new low
flush toilets, restrictors for shower heads and faucets, etc.
4. The septic system must be expanded as shown on plans prepared by Joel Greenberg RA
dated 9/1/00 R 219 -00.
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,
William Hedges
WH:kg Senior Public Health Sanitarian
cc:BI
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEWAGE DISPOSAL SY3TEIVI
OFFICIAL USE ONLY
SITE LOCATION TM# S� -2 — Z 3
OWNER'S NAME ,f-ur 1Z ;4 fA .. PHONE
MAILING ADDRESS :F Z "'r`�
PERSON INTERVIEWED �i^.� A ;±:�i 44L PCHD Complaint #
ame & Kelationstilp i.e., owner, tenant, etc.
DATE !? /�' TYPE FACILITY
PROPOSED INSTALLER
ADDRESS
PHONE
REGISTRATION#
Proposal (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original sewage disposal system ,Different location
may require submittal of proposal from licensed professional engineer or registered architect.
We d e % /dn e- / / ol .V-- -.- e7- A -Q fi • c'S /� � -c 4 .os A-e 6,e-
G�
J,: = or�ner. or renJOrt�ed /agent.of owner .a
Rr a egnditions stat�a
5199
SIGNATURE -Iy �/ LJ �° �'�I �-e ��, TITLE DATE
Proposal approved with the following conditions:
1. Procurement of any Town permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name
b. Site Street Name, Town and Tax Map number.
C. Location of installed components tied to two fixed points (e.g.,house comers).
d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep
e. Installers' name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
Proposal approved_
Inspector's Signature & Title
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
PC -RP 99NE
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DEMATMEIT OF ]HEALTH • . '
Dlvlslon of Environmental Reap& ' Senices
4 Geneva Road 8/28,/2000
Brewster, New Yctk 10soo
Tel-(914)i18-6130 F=(914)218-7921
PUTNAM
STREET-7 LAINOS PLACE'' TOM VALLEY Txrw o 75.15-2-23
NAM WILL °Z.AM PFISTER PHONE 28 -6638 pCHD
MA IN(IADDRESS 7 LAINOS PLACE,PUTNAM VALLEY,N.Y, 10579
DESCRIPTION OFADDITIO-4 2 BEDROOM ADDITION
h'U&MBER Of'- FNISTMG BEDRO.OM 3 PROPOSED # ®F BEDR00iVS 4,•
(FROM CERT. OF OCCUPANCY OR '
CERT6ICATI4` TRCM. BUILDWO INSPECTOR)
*Any addition which is considered a bedroom requires formal approval ofplans•(Construction
- Pea h-,S) prepued by ATigf'essional Engineer or Registered Architect In accordance with
applicable sections of the Putnam Count} Sanitary Code '
Please submit this form and the following to Putnam County Health Dept., 4 Geneva Rd.$
Brewster, NY 10502, Phone 278 -6130.
1. C:ettified check or money order for S 100.00
2, Sketches of existing floorplan (drawn to scale, all living area Including basement)
NOII professional sketches are acceptable ,
3. Two sets of proposed floor plan (drawn to scale; with name, street, and tax map #j ,
6 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 w ells and septic systems within 200 feet of the property line.
Contact 4his office with any questions.
5. Copy of Cert, of Qecupaney from Town or Certification from Building Dept. with legal
bedroom count of dwelling. .
Comments °
Aug 29 00 03s13p BUILDING DEPT
AUG -29 -21308 0212
l�
DEPARTMENT
• • t)iviaioa � Oi Erivironme
4 Geneva Road, Brews
(9M) 27
9145268806
• HEAtYH
i Health Servttes
New York 10509
P.02
KRUCE R FOLEY. M.S.
AmIn4 Pnblic'.H0111h Oua l.t
Putmmni Cdunty Dept of Health
4 Gene► Road
f�raireter.ldY 10549
Re: WILLIAM PFISTER
RtildCnCC
Te.YMap 74,15 -2 -23
(TbA1Tl PUTNAM "'VALLEY
t
Oa;ntlemen: '
Aecordirtg to re cords maintained by the T*%Nl% the above noted dwtlling
15 i
18 NOT
. _ �ri*4glia «�atp Tetitin code and -the tptal number of bedrooms on record -
is—
This inronulion ba been obtained from:
CBRTiFICATS OF OCCUPANCY: ►
ASSESSOM RECORD:
OT'HRR
n..:liJ..., Y..c..nttt►�
TOTAL P.02
p.I
0
6�j� N�V 25i �� �N'! �� gx�sT'' .
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01V
WILLIAM & BETTY PFISTER
LOT "B )l .
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Puli'mam. i OUhtY N-1-p art'ment of Health
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of Env4 ion M H -�alth Service
lwclved a's, nat::�d for with
Cif the
Irriq
:,.arn County 1...i a Vin D c p, a I -,,nt.
ignature & Title wt 97
JOEL L. (5REENBER6
.7 77.
R 0 H I T E C T
2 MA=T ROAD NORTH
KAHOPAC, NEW YORK 10541
DRMN6 TITLE:
ADPITIOW IDIS054b
m I z \V m p F
RVANOWas
OATEN71--
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.41
PRO.MT NO,
7 I-AIWO Pu&c0eL..-.
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BRUCE - R. -FOLEY
u Director
....-,:-..�LOPETT.A.MOI,TNAIR-T-R,.
4'.
Associate Public Health Director
Director of Patient Services
DEPARTNE, NT OF HEALTH
I Geneva Road
Brewster, N w York 10509
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) 278-6082 Fax (845) 278 - 6648
September 22, 2000
Joel Greenberg R.A.
2 Muscoot North
Mahopac NY Re: Addition- Pfister - 7 Laino Place
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 75.15-2-23
Dear*Mr. Greenberg:
I
I have received and reviewed the plans for the proposed addition of the above-mentioned
residence. The proposal for the addition has been approved as per plans bearing the approval
stamp form this Department dated September 22., 2000 The addition is approved with the
--- ----- -- - following-conditions-
I The total number of bedrooms must remain at—Five without prior approval by
this department.
2. The area of the existing sewage disposal system, and its expansion area, must be
-maintained.,
musf-be-u�ddatedd with`�4ate�r
flush toilets, restrictors for shower heads and faucets, etc.
4. The septic system must be expanded as shown on plans prepared by Joel Greenberg RA
dated 9/1/00 R 219-00.
Ahy 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 yaurrs—.- ........
William Hedges
WH:kg Senior Public Health Sanitarian
cc: BI
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner MP—,9,&MR,5, iVm. PFgi-Tee-, Address 70;wl PL., PU-T.VAi-i'6Let&y'
75 /0
Located at (Street) 7iAiNan FLAO�E- Tax Map .15 Block 2 Lot '23
,5799
(indicate nearest cross street)
Municipality -y-�6'..Vw o uLj_.gy Watershed. Uuv� Y-j ZvEy--
I
SOIL PERCOLATION TEST DATA
Date of Pre-soaking k3j/Z:7
Date of Percolation Test
............
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ep 'th I I
........ ...... .. ..
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X:
Hole No
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No
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Start . ..... ..
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Surface
Stogy
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r
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prep A
Rutz
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0 y 3,Z - 100,50
S
'Z3 IZ6
6V,
2
10,51 - lhoo
18
3
4
5
A-,
2
3
4
5
2
3
4
5
NOTES: 1. Tests to be repeated at same depth until approximately equal percolation rates are obtained at each
percolation test hole. (i.e. :5 1
min for 1-30 min/inch, s 2 min for 31-60
min/inch) All data to be
submitted for review.
2. Depth measurements to be made from top of hole.
Form DD-97
TEST PIT DATA 2
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
UEEPTH .. HOLE NO:.
_ HOLE NU
G.L.
1.0' GAKm1T DAM _
1.5'
2.0'
2.5'
3.0'
3.5'
4.0'
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
9.0'
10.0'
Indicate level at which groundwater is encountered Z% j g
Indicate level at which mottling is observed Z,>
Indicate level to which water level rises after being encountered IVIA
Deep hole observations made by: 15iEt, Gegggnpe6 Date
Design Professional Name: E L RQ5NB
Address: "Z A&Q-GC,p P- ° I e>R:t-k
Signature
11
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