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04627
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PUTNAM COUNTY DEPARTMENT OF HEALTH
Division of Environmental.Health Services, Carmel, N. Y. 10512
CONSTRUCTION PERMIT FOR SEWAGE DISPOSAL SYSTEM' %���h
Town or Village
r!r'Y6'�✓+E..rR rf✓.+� section_ —_ Block _,:� %/�
,
Subdivision Lot Job n'
Owner 4c'-v IAIC, Address /� s7�t'i/C�°�f�'/ l�(!!!}L— /1%� /Y✓ -��
Building Type Ile '�/1FL'/ta Lot Area Ac.
Number of Bedrooms
Separate Sewerage System to consist of Gal. Septic Tank
To be constructed by �/ V � CA 44 G'VA-_'.
Water Supply:
Other Requirements
Public.Supply From
Private Supply to be drilled by
Address
Total Habitable Space Square Feet
h
Z al lineal feet X width trench
Address
I represent that I am wholly and completely responsible for the design and location of the proposed system(s); 1) that the
above described will be constructed as shown on the approved amendment there to and in accordance with the standards, rule,
County Department of Health, and that on completion thereof a "Certificate of Construction Compliance" satisfactor
be submitted to the Departmeht, and a written guarantee .will be furnished the owner, his successors, heirs or assig byl
place in good operating condition any part of said sewage disposal system during the period of two (2) years i ed7a�
ante of the approval of the Certificate of Construction Compliance of the original system or any repairs theret 2*tfip
will be located as shown on the approved plan and that said well will be installed in accordance with the standards, ule� r
County Department of Health.
Date /G7 Signed z
Address 6 .Si691�fit-
APPROVED FOR CONSTRUCTION: This approval expires one year from the, date issued unless construction of
revocable for .cause or may be amended or modified when considered necessary by the Commissioner of Health. • An
requires new permit. Approved for disposal of domestic sa itary sewage, /or riv a ater supply only. ,
Date By ! Title
t F
PUTNAM COUNTY.- DEPARTMENT -OF- HEALTH -
Division of Environmental Health Services, Carmel, N. Y. 10512
Healthwill
builder will
of the issu-
ed above
Putnam
Yaken and is
construction
7 �1l f
CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM PO 1 v,4 01 V,4 Z
Town or Village
Located at / ~f b!At E e y A?a,-; P Section I Zo Block q¢ ^7 i
Owner A" ��% Lot 34 Job
Separate Sewerage System built by" I Inc Address
Consisting of V00 Gal. Septic Tank ��� lineal Feet X S� width trench
Other requirements
Water Supply: Public Supply From
Private Supplyyz Drilled By Vd,- d,71 F4,dIer sr=-w
Address
} Building Type �41�61 No. of Bedrooms Date Permit Issued
Has Erosion Control Been Completed?
A I certify that the system(s), as listed serving the above premises were constructed essentially as shown on the plans of the completed work (copies of which are
,%\ ached), and in accordance with the standards, rules and regulations, plans filed, and the permit issued by the Putnam County Department of Health.
mac/' i 9
73 & L� o/
Certified by P,E. R.A.
Address ze 74, f4) f�� /� >dC'f /�c� i!!i/�`!c'z� %/,d License No. lle4474r
N
Ion occupying premises served by the above system(s) shall promptly take such action as may be necessary to secure the correction of any unsanitary
s resulting from such usage. Approval of the separate sewerage system shall become null and void as soon as a public sanitary sewer becomes
nd the approval of the private water supply shall become null and void when a public water supply becomes available. ' Such approvals are
modification or change when, in the judgment of the Commissioner of Health, such revocation, modification or change Is* necessary.
.r
5066
YORKTOWN MEDICAL (LABORATORY BNQ �
P.O. Box 99 321 Kear Street
Yorktown Heights, N.Y. 10593
245 =3203
DATE COLLECTED
RESULTS OF EXAMINATION OF WATER
ER DATE RECEIVED
MILGOR 0/0 GORMAN 1
C, VILLAGE, TOWN & /OR NAME OF SUPPLY DATE REPORTED
BARGER ST.' BOX 262 PUTNAM VAILEY N.Y. 10 i i /i /73
PLING POINTF
WELL- L}
•"TERIA PER ML. (Agar plate count at '35 C). COLIFORM. GROUP (Most, probable No. /100mi.) HARDNESS; TOTAL -ppm rx
LESS THAN 202
ERGENTS ppm NITRATES (as N).- ppm IRON, TOTAL -ppm.
URIDE (F) - mg• /I
se results -indicate that the water was YES. of a satisfactory sanitary quality when the sa Is was collected
A. H. P.ADOVANI, M. T. (ASCP) j
PUTNAM ACRES, INC. F
i
_
JaS4 Putnam _Valle N Y
W) )ner^ or �.'l1rC. 1.a_ s(,r�01' ll �Cl.w.nv _. 4_ I`unic,j.pality_
.�•i�lf 14aciates`; Inc As
,:;; u. � 1. a ill C O it t r u C L C. d b'y _ S e; c T-To n
c/o M L Miller
78 Vau3hn Ave., New Rochelle L N. Y. 9471
..Locat; ion _ Street Lilcck
3 . bedroom ranch 34.
Bui Ldin.g `i'ype Lot
GUARANTY OP SEI' A RATE SE -11AGE SYST 10111
1. represent that I ara i.,Qaolly and corn )? etely re.sponsible foi, the
location., worla- unship, material, construction and drainage of the se' wag
disposal
system serving the above described prouert3, and that it has been
constructed as .sro1:•n on the app roved pls.n 'or approved amendment thereto,
_._..and in accordance pith the standards, rules and regulations of the Putnarn
County Dopartment of Health, and hereby --guaranty to the oVaaer, his succe.-
sor.s, h.cirs or assigns, to place in goodyoperatinv condition any part of
said syste.l constructed by- me. t-.hich fails to coerate for a period of two
years ir,,mediately fol.lo?�:ing the date of ._initial use of the sewage disposal
system, or any repairs made by me to such system, except where the . f`ailure
to operate: pro.;erly is caused bvr the ;ri).lf.'ul ��r negligent act of' the occu-
p,ant of the building utilizing the systerl.
Vhe undersigned further agrees to accept as conclusive the de -,
le.r7,1i l-lation of.' the IDirector of th T.li.vision of lnvlrormienl;ai Health. S --r•-
vices of the uutma,i County .Departrent of Healt'ft as to whc"tl.ar or not the
faia.ure of the system to operate xras caused by the willful. or negligent
act of 1 .the, .'aant of ...th.e...bl�llciang util.i: i:n�- tllc :ster _
occui sv
_ M . - .�r. _ ._ ..r.,_ .... _ .y _. . .
Dated this Y�� day- of October____ 19 �_ Si4nature46
T i t l
corporation, give mr>me
a newaitt' btreet
_ _ _ _ _ _ - _ - - _ .. _ Iake- Peekski 11,, 1V. ,_Yt. _
THREE (3) COPIES ARE REQUIRED WITH TnRE�; (') COPIES OF FINAL PLANS BEFORE
CERTIFICATE OF COi1P1aETI011,1 !:SILL BE ISSUED.
GUARAjNTOR IS REIQUIREID TO F1 r1,E NOTICE; OF DATE OF' FIRST USE OF SYS `1.1EM.
Division of Divironmen.tal Health Services, Putnam County Department of Health
COMPLITIO1I! REPORT PLox,NAVO COUNTY DEPARTMENT OF HrALTh
3/71 Division of Enviionrriental Health Services
1� J COONTY OFFICE Buit.nINu - CAWAEi NEW YORK
(his report is to be completed by well driller and submitted to County Health Department together with, laboratory report of
analysis of water sample. indicating water is of satisfactory bacteral. quality before certificate of constructio_ n corrlpliance is issued.
._. ��-«« ..'ice :.. -s
Rr=FOk t -IV UST B>` SU[3Mtl T.FD 1rd!T!i!P: 3U DAYS 01 V.". CO<L1PLE1 ION
NAME
ADDRESS
OWNER
PUTNAM ACRES, INC.
78 VAUGHN AVE a9 NEW ROCHELLE, No Yo
-
_ — iOCAT1ON
(No. ''& Street) (Town) _ (Lot Number)
..
OF WELL.
r
/
�'DOMESTJC El
'PROPOSED
LJ ES7ABLI HM,ENT FAk /rt TEST WELL
USE OF
WELL
AIR
SUPPLY INDUSTRIAL E OTHER'
LJ t
- .. DO, MING
(—I COMPRESSED CABLES ❑ OTHER
EQUIPMENT
❑
(—J P,OTARY AIR PERCUSSION PERCUSSION (Specify)
'CA51idG
LENGTH (lent) l
UlAMETER(IrchesJ WEIGHT PER FOOT ((�� — DRWE SHOE
�t WELDED RIYES nNO
El CASING GRO�UTIb"?
F1 NO
DETAILS
_.r
��
/�� {.,'��THREADED
.LJYES
--
YIELD
n ("'� j��� HOURS G.P.M. '
El RCOMPRESSED
YIELD (G.P.M.)
TEST.
LJ BAIL -ED PUMPED AIR
1
WATER
--,L=
hSEASURE FROM LAND SURFACE- STATItr(5peci/ ISO,,) DUPING YIELD TEST ! lest
y r ) ii
p1h of Completed Well
LEVEL
feel below Land surface: (go
MAKE
LENGTH OPEN TO AQUIFER. (feet)
SCREEN
DETAILS
SLOT SIZE
DIAMETER (Inches)
IF GRAVEL
Diameter of w ell including
GP.AVEL SIZE (inches)�FROM(leet) TO (!e-of).
PACKED:
gravel pock (indhes):
DEPTH FROM LARD SURPAC:
FORMATION' DESCRIPTION
Sketch exact locatlon of well with distances, to of least
two permanent landmarks.
FEET to FEET
«.. . �, - -. . r w .. � � - . .. _ -.2« .. - . wr � _ .. r k r 1... -. �. ♦.l • -•
!tJ
.. , .. - . .,
_. � . - .
<. . r.. ... r n , n r a � w W • ..6 .....� .
- if yield. was tested at different depths during drilling, list below
y
FEET
GALLONS PER MINUTE
DATE'WELL C MPLETE= DATE -OF REt.'ORT WELL DRiLLER� (S�ture)
Gen t! e, -: z1-n- :
A;
D 77" - -D 7
S� , TTC�:Z
Re: I'Irppelnty /7(;1r1vAA" lqcle'65-s. /IvC..
Located-at 11v"v'C-'e7Y "eOAO
T -
Section Blo'b::�: '-94'71- Ljoll & }
Tin-s let-'el is to
a du"-,--,-, I-_*'__eI__:.=_.
Tr
01'
an, o si
con_. e t'-f � a-, t an to ._" = J `_ 3cns Of S
tary- Code.
Countersi za Z-7 d
p - E
IlViL L el k4C_r.,e 42,0,
Andress
Tel ej 'n o e
Co -_:n -' San, -
t
Lam.. I _ — - --- - I 11� -
I _bli_ Hea-w— . u
sa
Mt 1
Very truly yours, PLI;rIM121
S zn e dz-; /� 4'1'�fl
Address
L A4
Tel- '7Lc n
124 vP
EN61%
9
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LORETTA MOLINARI
Public Health Director
DEPAR'TMENT 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
April 29, 2004
Bramer
24 Finnerty Place
Putnam Valley, NY 10579
Re: Addition - Bramer, 24 Finnerty Pl.
No Increases in Number of Bedrooms
(T) Putnam. Valley, TM #85.9 -1 -15
Dear Mr. Bramer:
ROBERT J. BONDI
County Executive
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 29, 2004. The addition is approved
with the following conditions:
1. The total number of at t'nree - 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 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.
Sincerely,
Michael Luke
Public Health Sanitarian
ML: ltn
cc:BI (T) Putnam Valley
- .,Q-''i ,W ^- .BRUCE``\ -R' ' FOLE1'' -.. = h • ..... -
Public Health irector
�m
4.
LORETTA MOLINARI RN., M.S.N.
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 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 (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648
ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET F%o0V,9 `C P L -KCt:- TOWN VF-t1, 'Y TXMAP9 $S. � - I -1S
NAMEW-\-410 MAR PHONE <845 PCHD# o -o
MAILING ADDRESS a--`1 F11J 0 F-PTX P QPt <' V QT-r pP t \ JPT -LSy., )0S-)7
DESCRIPTION OF ADDITION Ex'PP,,� s1 or)
NI TUNIBER 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 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., 4 Geneva Road, Brewster, NY
10509, Phone 278 -6130.
1. Certified check or money &W—rr foi-S 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 9)
*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 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.
OFFICE USE
Comments
Feb98
BFhouseguidelines
jr.
f
BRUCE R. FOLEY
Public Health Director
• .. fit.. -. - •... ,. .. •n .w. � M' « . iv. �. .... � .,
LORETTA MOLTNARI RN., M.S.N.
Associate Public Health Director'
Director of Patient Services
DEPARTMENT. OF HEALTH
1 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 (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Gentlemen:
Re: S-�'P�m 6 (---.
Residence
Tax Map S✓ `
Town yl C""
According to records maintained by the Town, the above noted dwelling
-, V
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
BFhouseguidelines
Building Inspector
AL . It
PUTNAM COUNTY DEPARTMENT OF HEALTH
D1�3
-W '.I
COUNTY OFFICE BUILDING, CARMEL, N. Y. 10512
...-DESIGN DATA SHEET-SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO.
Owner 4V,(,17A-,11o1n 4C46Z 1AAf Address
_
Located at (Street� C1.1VAlb�7-Y /2,0. Sec. Block
indicate nearer 'cross stree—t7
Municipalit Watershed "V
SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS
Hole
Number CLOCK TIME PERCOLATION PERCOLATION
Run Elapse Depth to Va-ter - Water Level -_
No. Time From Ground.Surface in Inches Soil Rate
Start-Stop Min. Start stop, - ` Drop in Min./in'drop
.Inches Inches Inches
2
A,'Al
AJ
4
5
7- Z_
- - ----
4
5
2
3
4
5
Notes: 1) Tests to be repeated at same
rates are obtained at each percolation
for review.
2) Depth measurements to be made
depth until approximately
test hole. A data to be
from top of hole.
equal soil
submitted'
". TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION
DFSCRIPT .�_OF,.,*QI.LS XNC.OUNTERED..-IN7TEST' HOLES
DEPTH HOLE NO. / HOLE NO.. C HOLE NO. 1X ,37-
G. L.
611
T211
2 11
36"
4211
;r
di
f�
4811
Type
widt enc .
�'��' �
5411
6011
r
6611
7211
7811
4r2
/,f
11-54vil /10/1"
d-
/I
Y
k:�I ..
f/
t
!7
INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED
INDICATE LEVEL TO .W�CH WATER LEVEL RISES AFTER BEING ENCOUNTERED
TESTS MADE BY : l; C °ice Cl�°<'R�.' ✓� a , Date `.�7�—
DE IGN
Soil Rate Used, -� Min/1 "Drop > S. D. .Usable Area Provided
go. of Bedrooms Septic Tank Capacity V'0 Gals.
lbsorption Area Provided By  L.F.x24f i!
t ,�S'o4/�'r� �e��cyi�.Q f✓�f> �i B; �. �� ,�'� i ��S`r"�ii.�A �3"` f�i? �
Type
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Lddre s s SEAL
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_ %ate �z��� -" , fT'f
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'HIS
SPACE FOR USE BY HEALTH DEPARTMENT ONLY:
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Rate Approved .0r0 57 Sq. Ft /Gal. Checked by
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��URV- Y MF;',.PROPERTY FOR
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'Co" r.,j 44.V,) L"N
71rL'c: /,VSVP, co
J. 'HENRY CARPENTER a 'Co.
'SrrUATLE AN
"''CIVIL f IL ENGINEERS & LAND_ _!�URVEYORS
TO
�WN OF PUTNA M VALLEY:
YORKTOWN: HMGHT
PUTNAM: COUNT Y. N
E. 'H FROmMHOL7. P.E. & L.S. -12406
DATE-
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