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HomeMy WebLinkAbout1038DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.48 -1 -18 BOX 11 01038 Pit �` ;LF mr r F N., 01038 DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 (914) 278 -6130 _ APPLI CAT ION'-'TO-- CONS'TRUCT`- N -VATER -WELL" - ,II 9 PERMIT # &j W- PCHD 0 ` .__.... i WELL LOCATION Street Address 10 Niles Rd. Town/Village/City Tax Grid. ' Number Patterson., NY WELL OWNER Name Thomas Duffy, Mailing Address". - 2071 Crompond Rd.,�Yorktwn Hts, NY . OPrivate DPublic USE OF WELL 11 - primary �2 - secondary UcRESIDENTIAL D BUSINESS D INDUSTRIAL 0 PUBLIC SUPPLY Q AIR /COND /HEAT PUMP 0 FARM 0 TEST /OBSERVATION O INSTITUTIONAL 0 STAND -BY D ABANDONED 0 OTHER (specify C3 AMOUNT OF USE YIELD SOUGHT__,:�`gpm /# PEOPLE SERVED 01- /EST. OF DAILY USAGE /,Sd gal 13 REPLACE EXISTING SUPPLY 13 TEST /OBSERVATION 13 ADDITIONAL SUPPLY NEW SUPPLY NEW DWELLING D DEEPEN EXISTING, WELL REASON FOR DRILLING DETAILED REASON K FOR DRILLING apt-D ly qLL — CAA ► t-L WELL TYPE DRILLED ODRIVEN C]DUG OGRAVEL OOTHER ;IS WELL SITE SUBJECT-TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. P.F. Beal & Sons Inc. 4 PutnamAve. Bt N ;WATER WELL CONTRACTOR: Name Address: > rewser > IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES X NO !NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY _. !..DISTANCE,: _TO_.�PROPERTY FROM NEAREST WATER MAIN: - LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED M❑ON SEPARATE SHEET QA AACI< dat ) s ature -ca C :Z C7 PERMIT TO CONSTRUCT A WATER WELL a' ..0 This permit to construct one water well as set forth above is granted under the piovis-i-oA'a of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that wtthiva X1'1 thirty (30) days of the completion of water well construction, the applicant shal�;; < -4Q) 1. Pump the well until the water is clear. � -< 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department: ;During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. ;Date of Issue: Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller L. ::. PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Canmissioner of Health ADDRESS - FIELD ACTIVITY REPORT - LYO• MAILING ADDRESS P.O. Box Post Office Up Code OVNFDI • i PERSON IN CHARGE OR INTERVIEWED Name and Title Sheet of Orig. Routine Orig. Complain Orig. Request Cmnpliance . Complaint Carp Final Group Illness Construction _ Reinspection Field, Sampling Only Field Conference Other DATE 1-52 TYPE FACILITY TIME TIME LEFT Explain INSPECTOR: TELEPHONE: Signature and Title PERSON IN CHARGE OR INTERVIEin1ED: I acknowledge this Field Activity Report. SIGNATURE: 6/86 TITLE: BRUCE E R FOLEY _ _ Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA_ MOLINARL.R.N., M.S.N. Associate Public Health Director Director of Patient Sery ices Environmental Health (914)278-6130 Fax (914) 278-7921 . Nursing Services (914) 278-6558 WIC (914)278-6678 Fax (914) 278-6085 Early Intervention (914)278-6014 Preschool (914) 278 -6082 Fax (914) 278 -6648 January 12, 2000 Thomas & Donna Duffy 10 Niles Rd. Brewster NY 10509 Re: Addition- Duffy - Niles Rd. No Increases in Number of Bedrooms (T) Patterson Tax # 25.48 -2 -18 Dear Mr. & Mrs. Duffy: 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 form this Department dated Jan. 11, 2000 The addition is approved with the following conditions: 1. The total number of bedrooms must remain at Thtee without prior, approval �.._.._ .� _.. ;. by...this_department. _...._.._�_.__..V_.. _ ..._.. _. _.._ ....._ _....__.._._.._... - ._.. ............. __._ _...�. 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 Patterson. If you have any questions, please contact me at your convenience. Very truly yours, Michael Luke ML:kg Public Health Sanitarian cc: BI DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509.. (91;0 278 -6130 C o BRUCE R. FOLEY. R.S Acting Public Health PRO���D ADDITION A. PLICATIC,V _ R= SIDE�VT IAL or� STREET: 19 NiLE�, -OYiN K'�-9-6 'DH Tx MR IT n ✓) f1�:'�E: 1)'b�R`Y` poN>�P\ OVY� P�,O��i= '�'1��' ���� FCHO PERMIT r MAILING ADDRESS Description of-Addition Number of existing bedrooms Proposed number of bedrooms from Certificate of Occupancy or Certification from Building Inspector Any addition which is considered a bedreoa 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 fore and the following to PUMAA.M COUM HEALTH DEPARTMEI T, 4 G511'zVA ROAD, B'= ASTER, NY 10609, Phone 278 -6130 with the following information. 3. 4. a Certified Check for $100.00. S'.�e`tcn "of�ezisting floo',� - p12,n (a11 yTiving' area �ncTu�ing basem =nt, ir 2ny) Non - professional drawing is acceptable. Sketch of proposed floor plan: Non professional 4- AINing is acceptable. Copy of survey snowing wall and septic location, to the best of your knowledge, Include date of installation if knNn. Include all wells and septic systems within 200 feet of property line. Any questions please contact this office. Copy of Certificate of Occupancy from Tarn or Certification from Building Dep 'artment of legal bedroom count of dwelling. OFFICE USE Co ments and /or conditions application August 1996 J.Jly 1995 LEC- '3 -.9 04:14 PM TOWN OF PATTERSON 9148 820 19 12- 29-1999 03!04PM FRL TO SEi'782019 P.�3 DEPARTMENT OF HEALTH Div11100% Of 8nvironmen:al Ftealch Serv;ces 4 Geneva Road, 6rewiter, ,Nvi Yoek 10509 014) 178 -6110 Putne.m Count} Dag'. of Health , 4 Goneva Roed $ravis::r, NY 10509 aenttemen: F'. NAUCS K Msy, P..s Aclino hV4 Millih olei'.1p Re: DOPY_.__^_ Rasidence TP -01ep S A % * 1-* A Tewn EtLeP-VH Mmlding to recoro3: m2ict ?ain: by ; ?t= Town, the above noted dwelling 1S NOT In comp! iance vfllb Tomr, code and tie tote, r►um,bv of bedroom$ on recd; d is......,.'... , This idormatior, has bear, o`nlaineld from: CERTIFICATE OF OCCUPANCY: — ASSESSORS MORD:_ OTHER MTAL P, 03 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL IlN'DIVUDAL ADDITION/REPAIR FORM SECTION A: GENERAL INFORMATION Name of Project NCO IIJII-e-S I (T)M T TM# Year of Construction Size of Parcel SECTIONt.' TOPOGRAPHY (Please check all appropriate boxes) 1. Milly LJRolling . ❑Steep Slope ❑Gentle Slope (]Flat 2. ❑Evidence of wetland ❑Low area subject to flooding ❑Bodies of water i ❑Drainage ditches URock outcrop YS N4 3. Property lines evident? w L� ❑ 4. Water courses exist on, or adjacent to parcel: ❑ l� 5. Existing individual wells within 200ft of the existing SSTS? L ❑ SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) 1. Physical character of existing SSTS area. A. 9-Level 7'Gentle Slope ❑Steep slope B. ❑ Well drained aModerately well drained ❑Somewhat poorly drained ❑Poorly drained C. Area available for SSTS. (Primary & Reserve) loom ❑Extremely limited ,f []Somewhat limited Adequate ft x ft D. INSPECTION Date f I Inspector �, s `' :'o ex idence of failure DEvidence of failure [Evidence of seasonal failure &4-s M rn C•7 J -------------------------------- . ----------------------- - - - - -- North-- - (Indicate iIOUSE ! L�.. (1) Indicate location of SSTS A. Size and type of septic tank gallons IlletO [Concrete OPlastic B. Type of absorption area 1. Fields ft. 2. Pits 3. Gallies ft. (2) Indicate setbacks, front street, backyard, and side yard dimensions (3) Show location of well (4) Show location of driveway (5) Note physical features (steep slopes, rock outcrops, streams/wetlands) SECTION E. EXISTL G WATER SUPPLY []PWS []Shared well Ofndidual well 015-ried ODucr 36-sing above ground COUNTS: REPAIRS ONLY: Status: As Built Inspection Required: As Built Submitted: As Built Inspection Done: Inspector: co * BRUCE R. FOLEY, F,.s Pl ctirg Public •Health 0: -e-: DEPART,V, = \T' 0; HEALTH 0. Envi: o. -_n;al Heall:h Ser rises Roa , 6. v.s:er, Nev, York 10509 (914', 78 -6130 - c, = ^;_D D T�C�� _ �R_SiD_NTIh! OPdY) d es : e�soN K1. TX r iw t15 a� dnt{►9 v P ; ;O`aTr'i�l on)� a PCH. PC. MIT X!.I L i i 3- ADDR_SS !O N i Ite..S W eCSON V v V. 1 dS 63 ~ Description of Addit 12n LION 't__'. ;�:�be, of existing - .._ C9 = ro_��se_ n.!;,ber of bedroo�s &,Pe of fro: Certificate of Cccup_-,ty o- Certification fro-i E� 1dir- insPecto- kiy edition shish is.cons`ceret a :__.__.:, rr,jires formal approval of plans (Construction Permit) Yrep_-ed by a Pro`_ssicn_l Engineer or Registered Architect n accordance with a- piic_'ie s :z iorts of the PutnZV County Sanitary Code. . ieas_ submit this fo --, ant the follc to RMKIN 000\,tfY HEAT TH D_PaRTMcM, 4 GE''! /A F`J�D,. E IS -E', ..r. 10509, • -. ,.,.._ 27c -5130 with tne. foll'dY+ing information. r _ I . Certified Check fo- $1C..00. W n %. Sketch of ex,istinc fiat- plan (al i ) iving area including basement, if any) T �c Non- professional is axept_bl: = -» 3. Sketch of proposes rloo- plan. f elzy Mon professional dr win; is acceptable 4. Copy of survey shcyring well 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 o c-� questions please contact this office. cn cn 5. Copy of Certificate of Occupancy -1 rcm Tarn or Certification from Building Department of 1egl bedroom count of dwelling. OFFICE USE Comments and /or conditions application s' August 1995 July 1996 (Revised) r. a DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 4 �'6LE BRUCE R. FOLEY �� � Public* Health Director May 26, 1998 Thomas & Donna Duff � 10 Niles Road Patterson NY 12563 Re: Addition - Duffy, Niles Road Increase in \'umber of Bedrooms (T) Patterson, Titi1? 25.48 -1 -18 Dear IIr. & Mrs. Duffy: 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 Mav 22, 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. x l 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 Patterson. If you have any questions, please contact me at your convenience. WH -tn cc- BI (T) Very truly yours, William Hedges Sr. Public Health Sanitarian 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 Gentlemen: BRUCE R. FOLEY, P,$ Acting Public Health Dire :to, - Re: Resid n e Tax Map According to records maintained by the ToNNm, the above noted dwelling IS IS NOT ,in compliance Nvith Town code and the total number of bedrooms on record is 0 This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: �C J OTHER - building InspectoreM. `0 rn Cn �-0 CD r ^— M rata tD M co © C�3 Zn J: r 1 _.. ' t - CVP I 1 r r -}-Od (A) ej i R_ L rr tl, exvl rn ,L-I%MA-;0 Ir-AT I L.3(-, t-N -e- e A .3 7 -;,!-'-.P RTMRMT Or. M. ilfi'll 1101L.NS11' PTANS AFI?F'OVED DOD 'P wEDPOO , CoUidl 0,T.y _A C. co rill, Li -2 pc'.7H- C,'�—? H A 0 PUTIVA1,11 COUNTY DEPARMYNT OF HEALTH YjOUSE fIT -ANS APPIPOVI'D MR BEDROOM COUNT GJLY; <: 9 I Lot 5295 Lot_ .5290 '1 Lot 5,889' 1 Lot 5288.,. N89S7'50 " F- `i ' =X 40:00 Q ' s, cor.' 3.2' x - — x . . x. Lot -5298 a•2 s _ 1=--- x Qi�e atoms . Z 9 : lefo/ning: wo// - m Lot _ $296.; 1 rj A�eca— :13, 86tS F Wig;.: n' K Lot. 530> Lot 5302 — — 0: M83 Acre o . J Lot 5R9 Q '?12 E Let . 5299 •0 m �. Lot -5298 t� m ' ' '?12 Let . 5299 1 st Q . From Story O' ..� D Frorrte 0 - lY' w: *JI In Lot. 5300 4 were o1 c ®.26.0' �{ E rod found 91 0 1.2' E - — ;�nneae : S89'57;150 Jr. Palo We OW, whi.