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HomeMy WebLinkAbout1341DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.78 -1 -36 BOX 13 a , , , h ., ., for 96T ,. m f - J- ♦ -�� I IN r IN IN IN 'llff 0 IN rl I a—Ed I — N -. h 01341 �stl PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL T**� • �'1 • please print or type pli hs�i Well Location Street Address: Town/Village: Tax Map ✓�� Map Block Lot(s) Well Owner: Name: dress: E#: Use of Well: X Residential _Public Su ply Air /cond /heat pum _Irrigation 1- Primary Business Farm Test/monitoring —Other(specify) 2- Secondary Industrial Institutional Standby Amount of Use Yield Sought - gpm # People Served Est. of Daily usage gal. Replace Existing Supply Test/Observation Additional Supply Reason for Drilling New Supply'(new dwelling) Deepen Existing Well Detailed Reason �. for Drilling Well Type ,,_nriilpd Driven ra a Other Is well site subject to flooding? ....................................................... ............................... Yes _ No Is well located in a realty subdivision? ........................................... ............................... Yes _ Nox- Name of subdivision 0 loot No. /I 7 Water Well Contractor: �.; Address: 0 Is Public Water Supply available site? ..................................... ............................... es _ No Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate she Date: , /whv Applicant Signature: 44,"11,10k" PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Departmei take appropriate action to assure that any and all water and 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. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam Co ty. C� L -!` Date of Issue /fir /. Permit Issuir)p Official: Permit is Non -Tra White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 Rev. 3/06 ALLEN BEALS, M.D., J.D. Commissioner of Health' - ROBERT MORRIS, P.E. Director of Environmental Health Boyd Artesian Well Co., Inc. c/o Henry Boyd 1054 Route 52 Carmel, NY 10512 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # ($45) 808 -1390 Fax # (845) 278 -7921 Subject: Proposed Well Knapp 18 Summit Rd (T) Patterson October 15, 2014 Dear Mr. Boyd: MARYELLEN ODELL " "County F.icecutive A field -inspection was conducted on.the above referenced lot by Vincent Perrin, Public Health Technician. The application to drill a new well is approved with the following stipulations: l 1. The well pump and any electrical components are to be removed from the existing well during abandonment. 2. A Well Completion Report (WC -97) shall be submitted no later than 30 days after the well completion by the permittee. Please contact me at (845) 808 -1390 ext.43131 if you have any questions. Sincerely, Vincent Perrin Public Health Technician cc: VP, file PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO ABANDON A WATER WELL please print or type PCHD PERMIT # Well Location: Street Address: TownNillage Tax Gri I� 'yam . y � Map Block Lot(s) Well Owner: Name: V Address: Well Type:_ Drilled Driven Dug Gravel Other Depth Data: Well Depth '99 ft Static Water Level ft Date Measured Use of Well: Residential Public Supply Air /Cond/Heat Pump Abandoned 1- primary Business Farm Test/Observation Other (specify) 2- secondary Industrial Institutional Standby Water Well Name: Address: / �? Contractor: Reason For Abandonment: Description To Be Performed: �ojf�Work Date: Applicant Signature: / PERMIT This permit, to abandon one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code, Subpart 5 -2 of Part 5 of the New York State Sanitary Code and/or Part 75 of 10 NYCRR and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall submit to the Department a certified statement that the information delineated on the application for this permit has been completed. Date of Issue rjPeitIssuing O ficial Title White copy: HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WA -97 I Doyd Artesian Well-Covq 7 1054 Rte. 52 Carmel, N.Y. 1.0512 NIS (845) 225-3196 Fax (845) 225-8420 AAMUTY wo-11 'Ok U-1_uLL. Lu- Lu A ii Ul U. "%" V.1 I Sky h qw '10k Aho S StOAM, i �1I i1 23.1 13' i W co bi w �r 00 33 rn ' ,' 38 . co o CD ,' 40? o . W 1 cn ' 39. 174 -4 C13 ao CYI AD a , A. •� , co N ��9 . 348 co 0 %sJ 6+ co 9p A Mo o� • �� bZ �; � 9a , / 13' i W "®ooty Calls" p SEP -TECH Inc. _---- - - -• -- -. B �i97 Stormviil ew�oek�2381 845 - 221 -9771 845- 226 -7606 s pry �3 ax r T fa�� r 2?- 7T............. A,2. p Aw� Nk, v�,� ORR, . . ........ X.- 4, tg,gng V-5-, d 'Ink . ..... MOM POW Ni 74 —X 'Aw sa, ftwo, Vr i lm W-. , - PUTNAM COUNTY HEALTH DEPARTMENT DIVISION.OF ENVIRONMENTAL HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM. REPAIR - ro .,� YES NO .. Internal Use Only ❑ Repair Permit issued in last 5 years (Not in Watershed ❑ Repair within Boyd's Comers, W. Branch. or Croton Falls Res. (!Delegated ❑ L Repair within 200 ft. of a watercourse or DEC= mapped.wetland ❑ .Joint Review SITE LOCATION 'i TM # - _8=/3G OWNER'S NAME '"� _I . PHONE # MAILING ADDRESS < l.: •:r ,. ,: r. 1: APPLICANT. Name & Relationship (i.e.; owner, tenant, c(orfractr} ` DATE .� A;( FACILITY TYPE . PCHD COMPLAINT # PROPOSED INSTALLER PHONE # Act ADDRESS �t r �:. III- REGISTRATION N/ LICENSE # f-Qi( Z-L. Proposal (include a separate sketch locating the house;''property lines, all adjacent welis within 200 feet of repair and the location of existing and. proposed tenches) NOTE: Repair must.be in same location and of same type as original sewage disposal system. Different location ,and proposed pump systems will require'submittal of proposal from. licensed professional engineer or registered architect. r I, as. owner, or reported agent of owner agree to the conaitions statea on. tnis torm f SIGNA U Mt TITLE ,. DATE _iV 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 fxed.points ' e�� `^� �f, d. System description (e.g., 1250 gal. Concrete septic tank, etc.) ► ° / p �! rat V 4'. , e. Installers name and phone number 3. System repair to be performed in accordance with the+a '�„� above proposal and conditions. t Proposal Approved_ Proposal Denied Ins' ctor's ignature & Tithes !� Dat • .. , apt r. . (. COPIES: White (PCHD); Yellow (Town BI); Pink (Installer), Orange (Applicant) PC -RP 99ML Rev. 8/05 FT? "Dooty Calls" So $ �- > n �A AD J .. �4q �•lc,,-> pI -A ,, �_aAk 4 V AA 4 �1311O6� 5 ®� AAoV-4 SEP -TECH Inc. O.- Box - 9 �tormville,'New York- 12182 ' d eJ 4 Cli- l� �t S V , 845- 221 -9771 845- 26 -7606 zs a� YATES mw %ENIA iur ier ��r IN I Putnar Lake RNEF� 66 67 ti QOM/ C � 9 9� y ell r' RD L p M 9 4 rUA., v 9g zi BRUCE R FOLEY - Public Health- fiimetor DEPARTMENT OF 1 Geneva Road Brewster, New York __ -- .------- .L� °:T'_'',t�== ivIOL-NARI• Teri'.;- 'I�i.S.N. • - _ ..__.�.., Associate Public Health - Director Director of Patient Services HEALTH 10509 Environmental Health (914)278-6130 Fax (914) 278-7921 Nursing Services (914)278-6558 Fax(914)278-6085 Early Intervention (914)278-6014 Fax(914)278-6648 WIC (914)278-6678 Fax (914) 278-6085 MEMO To: All Design Professionals, Builders and Property Owners From: Robert Morris, P.E., Senior Public Health Engineer Subject: Partial Submissions/Revisions Date: February 12, 1.999 In 199S the review of plans and the return of comments, if warranted, was constantly ahead of the time frame allotted by the New York City Department of Environmental Protection Watershed Agreement. The Department is still striving to improve the time frame involved for permit review and approvals. Some improvements are: 1) Additional personnel in the program. 2) New York City Department of Environmental Protection faxing comments /approvals - - - ...... __.__.__.. �). Reviewing the neighbor notification requirement to make the requirement less stringent. 4) Updating the filing system. However, it is also the design professional, builders and property owners responsibility submit documents with all pertinent information provided. A cover sheet must be attached to all documents not submitted with an initial complete application for a construction permit. The cover sheet must include the following formation for each project. . A) Owners name. B) Project address, municipality and tax map number. C) Document status, i.e., revision or requested additional information. The required cover sheet with assist in reducing the review and approval time frame. An example cover sheet has been enclosed. Your compliance with this requirement is appreciated. RM:tn Q,A ¢ COVER SHEET PROJECT (Owners Name): — � cl to STREET: I q �umtqi i vo � �s" SUBDIVISION LOT# MUNICIPALITY: TAX MAP NUMBER: IESIGN PROFESSIONAL- Ww;q)L 'h' DATE: 151 _.._ -- -•----•-- -..._. —� -. ._.. RLVljl 'flN'_...__.._.._.,_...._.... -- �'1.���•.��.• ✓l's�� fy�-�.__; - �._._.._ _...�_ .__...._.. ____...._�._... _..__ .__— __...__._.... 11 REQUESTED ADDITIONAL INFORMATION 11 OTHER ki a/ 'OM-: LAW OFFICE OF STEPHEi 9BELS PHONE NO. : 845 278 6101 Jun. 18 2002 01:30PM P2 -0- - - _ - -- -- - -_ _ 9rrot� nxwo a� e: �b�y % y4,R O'ti9g9 B- 2032 129.39' 1 f a -2033 B,Zc�97 / I � 83 �y -1996 -;F U) �V , f `3, 1995 0 6 0 994 �r 8�1g4� 8_1992 wi as map no. 1 Subject LOtet Underground except = nab cartlRcoticos propovd In a for Land Sury of Profentone, Sold certlflcat survey was Or gowrnmcntal and to the a: are not trans OWtten. Only capiee h orloinal of the consJdererd vaa L E G E N D COC�O�00 Stone Rattrtnlnp We# -- r►– +e —+r-�e Remy of Myad k wrw force - 1485 Rout PAona (84. (� 2000 /ns/ts Engineering, Surveying & LandsCape Architecture, P.0. All RlghM Reserved. ,ZOM : LRW OFFICE OF STEPHEN A ABELS PHONE N0. 845 278 6101 Jun. 18 2002 01:31PM P3 Survey of Property Prepared for f John Calbo ,�.19gg situate k7 j} Town of Patterson R _ X97 Putnam County, New York gti scale 1W MW 20' I s ', ✓. gg5 tl- • tV 3,10 8 -I9g3 a�1gga 'Map 9' of Putnam Lake', reeordad August 19, 1931 ad map no. 149K.. Subject Lots.- 6 -2(W through 8-2040, Indualvo Underground structures. if any exist not shown hereon, except as noted Certifications indicated horcon signify that this aurvey was prepared in accoroonco with the tetinp Code of Prtet1Ce for Land SLrve)o odoptod by the Ndw York State Aasoclatbn of Professional Land 94NOMM Ina. Sold ccrtlffcatione shall run only to the person for whom thht survey was prepared and on his befloff to the title CompanY• j' governmental agency and /or lending inOttutlan listed hereon. and to the. aseignses of the lending institution. Certirications j are not transfevaale to additional Institutions or subsequent COMM Only copies from the original of this aurvey marked with an original of the land surveyor's embossed seal shall be consfdemd valid Irue` copteS, P S / / / T f !r 7"57C—NG SURVEYING & LANDSCAPE ARCHITECTURE, P. C. 7se75 Route 22 • Brewster, New York 10509 Phone (045) 27C -4990 • Fox (645) 27$ —SJ92 www. incite —enq. coin nELOmM COAIpLZjEA OCTOBER Z 2000 MAP PREPARED: NOvEmBER J, 2000 This map may not be vsed In connection with a * -%rvey AMCCvit" cr mmd0f d0eume64 statement or meehani"m to obtain title insurance for any subsequent or future gronto= Unauthorized alteration or oadltlon to thfo survey is a vtolatfon of Section 7209, subdtvision'2 of the New York State Education Law. The uileeotion of survey maps by onyona other than the original preparor fs mAdeading. Contusing and not In the genarol welfare and benetn of the public. Licensed Land Surveyors shall not alter survey maps. survey Plans or survey plats prepared by athcrs. NICHOLAS 4CH , 7, New York Stgte Licensed No- 049JJO 00788.200 a. dw BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director 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 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 August 26, 2002 Sabino Larocca 1100 Rt 52 Kent Center Carmel, NY Re: Addition- LaRocca - 18 Summit Rd. No Increases in Number of Bedrooms (T) Patterson Tax # 25.78 -1 -36 Dear Mr. LaRocco: I have received and reviewed the plans for the replacement of the residence destroyed by fire.. The proposal for the replacement has been approved as per plans bearing the approval stamp form this Department dated Au ist 26, 2002 The addition is approved with the following conditions: .____...::_.. ���omusreia o — w priorapproval 1— ;..._The totil-lumber of- be, _:.._. 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 Patterson . If you have any. questions, please contact me at your convenience. Very truly yours, William Hedges WH :kg Senior Public Health Sanitarian cc: BI BRUCE R. FOLEY Public Health Director LORETTA MOLINARI RN., M.S.N. Associate Public Health Director W 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 *IC (845) 278 - 6678 Fax (845) 278 - 6.095 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: Residence Tax Map. Town 4-77 R—S Gentlemen: According to records maintained by the Town, the above noted dwelling IS-NOT in compliance with Town code and the total number of bedrooms on record is 2 This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD:.: s Building Inspector BFhouseguidelines CAIH l:'Eit,. ' Bedroo 2 N MB sr N 64 X 8.4 0 r— We 6'4 x 4'1 a4' 0 2868 jai o o — r & 8 1 OPL e•r X.95 g I Kitchen I' 20'7x13' (0 $1 Y d \ a 26Fj8 . 146 o / Sloped Ceiling \ �_ 0 \ I 2668 Been Required I f` ON \ �1 Sloped Ceiling / �.� 0 3 Master Bedroom Living Room ao 15'4 x 13' V 17'2 x 13'• N ?," 1 ' 2852 2852 3068 c,r 2852 2852 CMH -503 2844 Ranch Chalet Living Area 1215 -- C. These Floor Plans or Elevations are the property of Chelsea Modular Hornes Inc. and are Copyrighted, © and shall not be used without authorization. 0 o • y a 0- N N oa co rykti s, % .-G E N D__ . Stone Retaining wall m --- Rems. of Wood & Wire Fence In Pi p° Found 4 s-' to lJ