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631- 589 -8100
83.12 -3 -28
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PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PROPOSAL FOR SEWAGE TREATMENT SYSTEM REPAIR
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FES NQ/ Internal Use Only PERMIT # -071 - 11rJ v
❑ 19, Repair Permit issued in last 5 years LVNot in Watershed
❑ Repair within Boyd's Comers, W. Branch or Croton Falls Res. ❑ Delegated
❑ Repair within 200 ft. of a watercourse or DEC - mapped wetland ❑ Joint Review
SITE LOCATION TOWN f //�/9d� (//9Z40/TM # 3 , 1 a '3 "oeg
OWNER'S NAME 1C'eG�� /9 a1* PHONE # fy-- _61
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MAILING ADDRESS 1 I) TrjjArn.VA't4Fy In
APPLICANT 2 - 7a4e 63 PV(.
Name & Relationship (i.e., 49k, tenant
DATE S-� Y, % f FACILITY TYPESftA r-- PCHD COMPLAINT #
PROPOSED INSTALLER Z)j PHONE #
I
ADDRESS C 1 ,,,/ .� REGISTRATION /LICE SE # 116 7- z
�eh jePro sal (include separate sketch locating t�house, property lines, all ac ntwlls within n 200
feet of repair and the location of existing and proposed system)
NOTE: The Department may require submittal f proposal from licensed pr fessional depending on the
natuu(e and extent of t rep r. f r
/ r )a40-r— l"'�.yrifJJ �P�D i� _ !► O�v �6�D _Ci 0 Ir� i s a0i �..
I, as owner,agree to the conditions stated on this form
SIGNATURE
(owner)
I, the septic installer,
TITLE Is Z-(/]
I
litions of this permit for the septic system repair
SIGNATURE TITLE 00 N4-A, DATE S' y�ll
(Installer)
(Installer) -
mRRaamd 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.
INTERNAL USE ONLY
PjMprt � f t ® ��posal Denied ❑
6 r 6 It
Inspector's Sig ature & Title Date Ex0iration Date
Repair proposal is in compliance with applicable codes Yes No ❑
COPIES: PCHD; Owner; Installer
PC -RP 99ML Rev. 2/07
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SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI,1N*,*' 9N
Associate Commissioner of Health
Darrow
42 Orchard Rd.
Putnam Valley, NY 10579
Dear Ms. Darrow:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT I BONDI
County Executive
February 16, 2005
Re: Addition — Darrow, 42 Orchard Rd.
No Increases in Number of Bedrooms
(T) Putnam Valley, TM #83.12 -3 -28
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 February 15, 2005. The addition is approved with the following conditions.
1. The total number of bedrooms must remain at two without prior approval by this
Department.
2 Tho afea-u the exis`iiiig-sewage cristio-a system,- and- ks-cxpans ors area; r ist 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.
Any 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.
ML: lin
cc: BI (T) Putnam Valley
Sincerely,
Michael Luke
Public Health Sanitarian
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 .
LORETTA MOLINARI
Public Health Director
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 10509
Environmental Health (845)278-6130 Fax(845)278-7921
Nursing Services (845) 278 - 6559 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
PROPOSED ADDITION APPLICATION zi- -fDVQnM.rTAT nXT
ROBERT J. BONDI
County Executive
STREET0YZV1Q4CJ �acl TOWN Vsj TX MAP # 0.) 1 3
NAME Vejl�4_Day-rvL3 PH0.NE_S2_9'-(o1]53PCHD.# �)7-01-
MAILING ADDRESS L42- 0 n_ r P-oacl - -P,+na,,n Val" 63y 10,V1
DESCRIPTION OF ADDITION 1�i
0.
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
val of pjans (Construction -
_Rpro
piciTafed'by-a. ProfessloiMlIniiijeet orReglftered1ff chiW0fiffWdcdfdMd'd`Witlf
applicable sections of the Putnam. County Sanitary Code.
Pleasie submit this form and the following to Putnam County Health Dept., 4 Geneva Rd.-9
Brewster, NY -10509, Phone 278-6130.
1. Certified check or money order for $100.00
2. Sketches of existing floor plan (drawn to'scale, all living area including basement)
�ssional sketches are acceptable
w wo sets o roposed floor plan (drawn to scale, with n_ ame, street, and tax 'map #)
0 sets
sketches are acceptable
4. Copy ofsurvey showing well and septic location, to the best of your knowledge. Include date-
of installation if known. Label'all wefts 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.
LORETTA MOLINARI
Public Health Director
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New 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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
Putnam County Dept. of Health
1 Geneva Road
Brewster, NY 10509
To Whom It May Concern:
ROBERT J. BONDI
County Executive
Re: `Q- d rG7�►'!� l L
Residence
Tax Map
Town Diu- —* ✓G¢�/
T
According to records maintained by the Town, the above noted dwelling,
is
IS NOT
In compliance with Town code and the total number of bedrooms on record is
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER:
Building Inspector
housegmdelines
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DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York .10509
Tel. (914) 278-6130 Fax (914) 278-7921
October 29, 1998
Ronald Mahnert
42 Orchard Road
Putnam Valley NY 10579
Re: Addition - Mahnert, 42 Orchard Road
Increase in Number of Bedrooms
(T) Putnam Valley, TM# 83.12 -3 -28
Dear Mr. Mahnert:
BRUCE R. FOLEY
Pu�?ir; 'tirC�f�- vz.pirector
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
October 29, 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, restructures for shower heads and faucets, etc.
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.
WH:tn
cc: BI (T)
Very t rs, -�—
William Hedges
Sr. Public Health Sanitarian
Y.
ilk-
DEPARTMEN'T'OF HEALTH
Division ,Of Environmental Health Services
4 Geneve• Road, Brewster, New York 10509
*4) 278-6130 - -
Putnam Cdunty Dept. of Health
4 fteva, Road
Bmwiter, NY 10509
Gentlemen:
WWCE FL FOL , EY.
At Oth M"T'
tine. ie i( I
Re:.
Residon
q2 op
orr'kAe4 '
Tax Map I — V--4,
Town
According to records maintained by the Tovvn, the above noted dwelling
Is
IS NOT .
in com cod and the total number of bedrooms on record
phince. %0th OAM e
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER
ns
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DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
August 27, 1991
Mr. & Mrs. Ronald Mahnert
42 Orchard Road
Putnam Valley, NY 10579
Re: Proposed addition
Mahnert, 42 Orchard Road
(T) Putnam Valley TM #116- 5-1.42
Dear Mr. & Mrs. Mahnert:
JOHN KARELL Jr., P.E. M.S.
Public Health Director
I have received and reviewed the revised plans for the proposed addition to the above
mentioned residence.
The plans indicate that a 141 6" x 12' addition will be added to the existing one bedroom
residence.
The survey indicates that sufficient% area exists to expand or repair the sewage disposal
system, should it become necessary in the future. Therefore, based on the information
submitted, the above mentioned addition is APPROVED with the following conditions:
1. The total number of bedrooms must remain at one without prior approval by this
2. The area of the existing sewage disposal system, -and its expansion: area, must be .
maintained.
3. All plumbing fixtures must be replaced or updated with water saving devices, i.e., 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,
William Hedges
Sr. Public Health Sanitarian
WHljP
cc: BI (T) Putnam Valley
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DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(91 4) 225 -0310
August 9, 1991
Mr. & Mrs. Ronald Mahnert
42 Orchard Road
Putnam Valley, MY 10579
JOHN KARELL Jr., P.E., M.S.
Public Health Director
Re: Proposed addition
Hahnert, 42 Orchard Road
(T) Putnam Valley TM #116 -5 -1.42
Dear Mr. & Mrs. Mahnert :
I have received and reviewed the plans for the proposed addition on the above
mentioned parcel.
That plans indicate that a 14' x 21' (560 sq. ft.) 2 story addition will be added
to the existing residence. The proposed addition represents an increase in
living area of approximately 100 %..
The addition, as proposed, can not be approved for the following reasons:
1. Additions of greater than 15% .'of existing f loon erea� � must• "be able `to ..
demonstrate that adequate sewage disposal area exists to expand the system to
present code requirements. Minimum setbacks of 20' from structure and 10'
from property lines severely limit the area available, to expand or repair
the sewage disposal system, should it become necessary to do so in the
future.
Please resubmit plans showing an increase in living area of approximately 15% of
existing floor area for our review and approval.
If you have any questions, please contact me at your convenience.
WHi3p
cc: BI (T) Putnam Valley
Very truly yours,
William Hedges
Sr. Public Health Sanitarian
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