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. PUTNAM COUNTY HEALTH DEPARTMENT Q
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PRUPOSA�. FOR 99WAGEIS�SAL
OFFICIAL USE ONLY
V'•
SITE LOCATION r-- ,TM# 1 I NA
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OWNER'S NAME -1 iJc.k t- ,- PHONE 4 'Av" 39%2
MAILING ADDRESS 31 /-� la R is
PERSON INTERVIEWED PCHD Complaint #
ame & Relationship (i.e., owner, tenant, etc.
DATE TYPE FACILITY f );h„ /1e- s
PROPOSED INSTALLER. R UMA s ►c. PHONE 6114 - 7 3I- 110 S'
ADDRESS -1 Da g t4J4ap K12 Cooydr,4T /&Ai4�REGISTRATION# b 6�p
7 0' dV� 1",;,b I
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 pbmittal of proposal from licensed professional engineer or registered architect.
&A) �, I FIAsc c i54,Jk M R&Ol U& Soo vial s rxte, % 7,+�'A
q,,t u-5 h�L `.T l +-Al�i /v 4 �,S'�✓�iz? c4 . [� rUG% "1 �t GC*s•� /.'cccwitc �?' ilrG�2_ /l�L� /�"�%�
I,:as owner; or reported of owner�a�ree :to the renditions stated on this form:
SIGNATURE TITLE B/114.= DATE
Proposal approved with the following conditions:
1. Procurement of any Town permit, if applicable.
C%l 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 bee rformed in accordance with the above proposal and conditions. -
Proposal approved
6
pector's Signature & Title DATE
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
PC -RP 99NE
SHERLITA AMLER, MD, MS, l'AAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
John Pizzella
Pizzella Brothers Inc.
7 Dogwood Road
Cortland Manor, NY 10567
Dear Mr. Pizzella:
R ®BERT .I. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 10509
June 13, 2006
Re: Proposed SSTS Repair- Maroulis
37 Maple Road, (T) Putnam Valley
T.M. # 91.24 -1 -1 .
This office has received and reviewed the most recent set of plans for the above mentioned
project. We would like to offer the following comments for your review and consideration.
I. Proposal for repair is not in the existing SSTS area, therefore a professional engineer or
registered architect needs to submit a design. Field test will be required to be witnessed
by this Department. If the existing SSTS area is used and the same type of system is
installed, an engineer or architect is not required. .
2. Based on field inspection made by Joe Digit, Environmental Health Aide of this
Department, a plastic tank is acceptable. However, a minimum tank size of 1000 gallons
_. 1S renuire 4:
3.- If the existing area is to be excavated toc determine ~what type of system is installed, this }
Department is to be notified before the excavation.
4. If the current SSTS tank is failing, a separate permit for tank only replacement should be
submitted immediately for approval. The tank should be replaced as soon as approval is
granted in order to prevent an SSTS failure to the surface.
This office will continue its review upon consideration of the above mentioned comments. Please
feel free to contact me at ext. 2157 if any questions arise.
JSP:mcb
7 osepy trul yo ,
h S. Paravati, Jr.
Assistant Public Health Engineer
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
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VON _pr -ES.Va 4cetley, PTO.; � J OF PROPERTY LOCATED IN THE ±
TOWN OF PUTNAM VAL,
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JAMES W. 1215iA JiZ.
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UNE
r lnffltrC-1tor- -Chem r
The High Capacit I.afilma or chamber offers maximum inte)at've
temporary age together with a large total effective infiltr
10 -inc nigh louvered sidewall. Also available in SC /Shallo
4
(Weight (WxLxH)............ 34''x75 x16 ",(85cmx
............................. .38 Ibs (17.2 kg) `:
e ed Sidewall Height....104 (25 a1 (433 L)
Storage Capacity ................ . 9
cm).,
Hi h Cagacity SudeWinder" Chamber
Infiltrator's revolutionary, patented SideWinder sidewall design provides
the largest effective sidewall infiltrative surface area together with a large
total storage capacity. Also available in SC /Shallow Cover model.
,
Size (W x L x H) ................ ;.34 "x 75 ". x96" (85.cm x,191 cm x 11 cm)
Weight ... ............................:37 1bs (1.6.8,kg)
Storage Capacity .................112.5 gal (426 L).
Louvered Sidewall Height .... 10" (25. cm) 1,
Equalizer® 36 Chamber
The Equalizer 36 chamber fits in a 24- inch -wide trench and features the SideWir
Sidewall. The chamber is available with 9" (23 cm) and 6",(15 cm) invert end. plat
- or a variety av-.iletle in CruickCut model.'
Size (W x L x H) ....................22" x 100" x 1.3.5 ". (56 cm ,x254 cm x 34 cm)
Weight ... .............................33 Ibs (14 ;9 kg)
Storage Capacity ........... 87,5. al 331 L
g ( )
Louvered Sidewall Height..._ 10.3" (126 cm) > a
Contour TM Swivel
The Contour" Swivel accommodates the
natural contours of sloping sites and to
avoid site obstructions. The unit allows
for change in trench direction from
0°- 900 left or right. For use with the
Equalizer 36 and Equalizer 36 QuickCut' chambers.
lipe Ties
'ifiltrator Systems may provide pipe ties to strap or secure a pressure
lose pipe to the top of any chamber used in a pressure dose system
11 measurements are nominal.
Contour" Swivel EPS
STh Co ntour'" Swivel EPS accommo-
tes the natural contours of sloping
sites and to avoid site obstructions.
The unit allows for change in trench
direction from 0 -to -90 degrees, For
use with Standard chambers.
Chambe p TM
Ah
The ChamberSpacer helps to maintain a
ANOWIL 4" (10 cm) or 6" (15 cm) separation
qqw* between chambers in bed
applications and side -by-
side configurations.
I acknowledge receipt of this report: SIGNATURE:
02/96 Title,
/F�ioq j
BRUCE R. FOLEY, R.g
Acting Public Health 0 : :e;
DEPARTMENT OF HEALTH
Division Of Environ Mental Health Services
4 Geneva Road, 6re�vster, New York 10509
(911.) 278 -6130
PI<- MP OS =D ADDITIO-( AP?LiC:,TICfi _ (RESIDENTIAL ONLY
STREET: TOti'i `� V-�-�-Y--(-- TX M4P -Ot
.2 ( PCHD PERMIT # S _. Q (4
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�'4ILING ADDRESS
Description of Addition
1
:umber of existing be-t-ooms Proposed number of bedrooms
from Certificate of Occupancy or
Certification from Buildin= Inspector
>aj0WI
kiy addition which is considered a badracmi requires formal approval of plans
(Construction Permit) prepared by a Professional Engineer or Registered Architect
in accordance with applicable sections off the Putnam County Sanitary Code.
Please submit this form ant the following to P'JMNM COUNTY HEALTH DEPARTMEt�l.
4.G =NEUA ROe%D -
30,wrt the-ot Information.
1. Certified Check for $1010.00.
2. Sketch of existing floc- plan (all living area including basement, if any)
Non - professional drawing is acceptable.
3. Sketch of proposed f 1 oor plan. fit" 1�
Non professional drawing is acceptable j
4. Copy of survey shcYring 'rt'all and septic location, to the best of your
-knowledge. Include date of installation if known.
Include all wells and septic systems within 200 feet of property line. Any
questions please contact this office.
5. Copy of Certificate of Occupancy from Tovrn or Certification from Building
Department of legal bedroom count of dwelling.
OFFICE USE
Comments and /or conditions
application
August 1995
July 1996 (Revised)
- •.+s <eV'. �"..;;i:•r�•' .;L.y�i.��► `- 3 •.�is
Daniel Kruse
37 Maple Road
Lake Peekskill NY 1037
BRUCE . R. F LEA' _
:.;:. _��;.�c<.;.c:�,;c;� • �:�'�:x:.''PuS't�'�eatt'h ='C�rrector
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
February 18, 1998
Re: Addition - Kruse 37 Maple Road
No Increase in Number of Bedrooms
(T) R*:erserrTM# 91.24 -1 -1
Dear Mr. Kruse: P,� vaG(.j
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
February 17, 1998 and this Department's approval stamp.
Based on the information submitted, the above mentioned addition is approved with the following
conditions:
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1. The total number of bedrooms must remain at one 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.
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 Patterson.
If you have any questions, please contact me at your convenience.
Very truly yours,
Michael Luke
ML-An Public Health Technician
cc: BI (T)
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278-6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Re:
Residence
Tax Map
Town
BRUCE R. FOLEY, R.S.
Acting Public Health Director
Gentlemen:
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
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TOWN OF. PUTNAM VALLEY, 'i ;Application
•
Putnam County, New York. s 1
Pursuant to the Sanita Co e of the above Town, the undersigned ,he *eby makes APPLICATION to .
Install one .. ,.. ...... A -� l` ......
Name of "owner �:�' r.� .7���. .. 1
P. .0. Address ............. r ..,�. ,c.,c „rl�:. SPACE
Location 5 's.rCl ...................................... FOR
Block No..... . .. ............................. .....Lot No./j..(v. .. Z. —.,Q........ ... ' ✓ � ' ,1 y
Area of Land./06, ; , LYl Gr?.er .
. �� Xc�lcres.....lQ. ..,1�...Sq.
. .... ............
Maxim
um.No. of people expected to use facility........%- ........ ? t
Date installation will be . started .....
r! /i�?�1 ................ f L
NOTICE: A 'BLUE PRINT OR SKETCH showing (ll .boundary lines of property {2) ,buildings (3)!"l akes,stseams,' r`•, ;
wells, cisterns, springs, etc. (4) proposed location of facility, ' including drains,' 1VIUST BE FILED ,1If(ITIi
THIS, APPLICATION:
Name of Plumber........... ...
......
P. O. Address ................................................. .............................:.
k
Signature , of Applicant.. ................. ......
M I lr 'jlr�t� •
REMARKS ........................ ' ................ ............................:.. c
..........
...... .. ............................... ... ....,,..4 i��RyiJ�r t
.................. .. .................... ................................................................. ............................... ...... .... ..i.. ..t1 . .
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SURVEY
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TOWN OF PUTNAM VALLEY
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SHiRLITA AMLIER, MD, MS, EAAP
s Consmissionsr.of &e t{I;,,.
LORETTA MOLINARI, RN, MSN
Associate Commissioner. of Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT MORRIS, PE
Director of Environmental Health
ADDITION APPLICATION RESIDENTIAL ONLY
STREET 1� �O�S7i �' KC�O+c\�' ®''I�1 �e TAX
1P#
NAM E.'& a O l.) l \ S PHONE -I q c1 PCIfID#
MAILING
ADDRESS I MC�P� 2 QCA G\ Le.le- k—sk ( z&)-t, to 53 7
DESCRIPTION
ADDITION r
NUMBER OF EXISTING BEDROOMS PR ®POSED # OBE' I3EIDROOMS
V-\r \ l.. Y Il r) ...A
(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 subrn.it this form and the fotlow- ng to.Putna�m Count.- Health Dept -;,l -Geneva Rd.,
-Brewster, NY 1050q' Phone: (845) 278 -6130.
1. Certified check or money order for $100.00.
2. Sketches of existing floor plan (drawn to scale, all having area including basement)
3. Two sets of proposed floor plan (drawn to scale with name, street and tax map #)
*Non- professional sketches are acceptable
4. Copy of survey showing well and septic locations 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.
V5. 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
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
t-
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,.... -� SHERLITA.AMLE>MD•;MS; EAA,E -,,:.
Commissioner 6X-21
1
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health.
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 16509
Town Legal Bedroom Count
ROBERT
County Executive
Re: 1 r `� n � t,- l (Owner's Name)
Tax Map #: 9 2 - (-
Address: 37 ►QL E _
Town: itr-Ukg, UA L L G
Year Built:
According to records maintained by the Town, the above noted dwelling,
is ✓ in compliance with Town Code.
�2
is not in compliance with Town Code.
a Ot
The Legal Bedroom Count 1s:
t� l
This information has been obtained from:
Certificate of Occupancy:
Other: (ASSG�SSQ iZ-' S P.Cjbkz-p i
_I O?
Building Inspector Date
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Nursing Services (845) 278 -6558 Fax (84'5) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention/Preschool (845) 278-6014 Fax (845) 278-664R -- -
SHERLITA AMLER, MD, [CIS, EAAP
Commissioner of Health
LORET I'A MOLINAR19 RN, MSN
Associate Commissioner of Health
Thomas & Jennifer Maroulis
37 Maple Road
Lake Peekskill, NY 10537
Dear Mr. & Mrs. Maroulis:
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 10509
September 29, 2008
ROBERT J. BONDI
County Executive i
ROBERT MORRIS, PE
Director of Environmental Health
Re: Addition- A- 184 -08
No Increase in Number of Bedrooms
37 Maple Road
(T) Putnam Valley, T.M. # 91.24 -1 -1
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 September 29, 2008. 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. 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
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 (845) 278 -6130, ext. 2261.
Sincerely,
J V2ez,
Gene D. Reed
Senior Engineering Aide
GDR:kly
cc: BI, (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 Far (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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PUTNAM COUNTY DEPARTMENT OF HEALTHe �m
HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY
h 9/08/2008
BEDROOMS A g �g
ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE
PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL
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SI NATURE 8 TITLE DATE- =
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PUTNAM COUNTY:DEPARTMENT OF HEALTH
HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY
PAM eqm
BEDROOMS '? — .8 — aS
9�08�20�
ALL SUBSEOUENT REVISION /ALTERATIONS TO THESE HOUSE
PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL
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SIGNATURE & TITLE
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ROOF PLM
APPITTla46 & ALTERATIONS TO
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37 MAPLE ROAR
DRAWING & DESIGN
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