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631- 589 -8100
41.06 -2 -6
BOX 20
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02248
Don & Patricia PEARLSTEIN
DEPARTME14T OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914):278 -6130 A� A,'all
._...... �.x..APPLICATION -TO, CONSTRUCT A' -WATER =-WELL
PrRn PRRMTT A
WELL LOCATION
Street Address
492 Lakeshore
. Town/Village/City Tax
Drive, Putnam Valley, NY' l.&
Grid Nymber
-Q -&&
WELL OWNER
Name
Don & Patricia
Mailing Address
Pearlstein, 60 Sutton Place So.,
OPrivate
NYCOPublic
USE OF WELL
1 - primary
2- secondary
® RESIDENTIAL
O BUSINESS
O INDUSTRIAL
❑PUBLIC SUPPLY QAIR /COND /HEAT PUMP
O FARM O TEST /OBSERVATION
d INSTITUTIONAL O STAND -BY
0ABANDONED
0 OTHER (specify
O
AMOUNT OF USE
YIELD SOUGHT 5+ gpm /# PEOPLE SERVED /EST. OF DAILY USAGE gal
® REPLACE EXISTING SUPPLY ' ❑ TEST /OBSERVATION Q ADDITIONAL SUPPLY
O NEW SUPPLY NEW DWELLING) DDEEPEN EXISTING WELL
Existina well is under the ho s--_
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
WELL TYPE
®DRILLED
[3DRIVEN EIGRAVEL
0OTHEA
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No.
WATER WELL CONTRACTOR: Name P.F. Beal & Sons, Inc. Address:4 Putnam Ave., Brewster, NY
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
_y r
DISTANCE TO PROPERTY FROM NEAREST WATER MAIN:.
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
❑ON SEPARATE SHEET
2/24/97 (/
(date) V I ( gnat re)
:Malcolm T. Beal, Jr.
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of 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 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 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
Permit is Non - Transferrable
3/89
19
19 Permit Issuing Official
White copy: HD File Pink copy: Owner
Yellow copy: Bldg. Insp. Orange copy: Well Driller
ARTESIAN WELLS
WATER SYSTEMS
JET PUMPS
SUBMERSIBLE RUMPS
P. F. BEAL & SONS, INC.
4 PUTNAM AVENUE
BREWSTER, NEW YORK 10509 WATER TANKS
COMMERCIAL WATER SYSTEMS
11,430 lee4 ,
.....;.: ._.,.- HYDROFRACTURING
TEL. 279 -2460 - 2461 WATER CONDITIONING EQUIPMENT
FAX 279 -6613 'J-� ' MON-1 _
COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERIVICE
May 5, 1997
Putnam County Health Dept.
Attn: William Hedges
4 Geneva Road
Brewster, New York 10509
Dear Mr. Hedges:
In response to your request for neighbor notification and a
site plan showing distance to neighboring septic systems, I
have enclosed such information. The two contiguous neighbors
to Mr. & Mrs. Pearlstein are Dr. Roberta Coles and Mrs.
Barbara Hamburger, each of which has been notified, signed
notifications forms, and septic systems are 200' or greater
from the proposed well drilling location for Pearlstein.
I would appreciate your reviewing and approval of the well
drilling permit as soon as possible.
PLB /mm
enclosures
Very truly yours,
nc . __ -
c
Acting Public Health Director
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130 March 3, 1997
Don & Patricia Pearlstein
60 Sutton Place South
New York City, NY 10022
Re: W -11 -97
Well Permit Application
Pearlstein
492 Lake Shore Drive
(T) Putnam Valley
Dear Mr. & Mrs. Pearlstein:
I have received the application to relocate a well on the above mentioned parcel in the Town of
Putnam Valley. The following additional information is required:
1. The Tax Map I. D. Number is lacking on the application.
2. All surrounding sewage disposal systems within 200 feet of the proposed well must be
indicated.
3. All property owners within 200' must receive notice of your intent to relocate the water
supply along with a copy of the plans showing the proposed well location.
Once the above mentioned information is received, review will continue. Should you have any
questions, please contact the writer at your convenience.
Very truly yours,
William Hedges
Sr. Public Health Sanitarian
WIVJP
cc: P. F. Beal
M. O'Dell
b
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster,- New York 10509
(914) 278 -6130
FORMAT
NEIGHBOR NOTIFICATION
CONSTRUCTION PERMIT DATE
BRUCE R. FOLEY, R.S.
AaT4 .Public - Health '-Director-'--!:
RE: Department of Health Review of
Proposed Sewage Disposal System and/or-Well
NAME: O0 �--� ' /aim �rr'�.lev,,
, ,
ADDRESS: �VA L� /
TAX
Dear '_BAr
Please be advised that an application for a Construction Permit relative to the construction of a
s r well proposed for the above captioned property has been made to the
Putnam County Department of Health. Attached please find a copy of the latest site plan.
If you, have any- questions; concerns- or- information which may bear on the Health_ -- Department's
review of this application, you may call Mr. Hedges of the Health Department at 278 -6130.
RECEIVED BY:
4, i
TAX MAP:
BRF /JP
syswell
Very truly yours,
BY
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e�'3 •� niG. — Surveyor,
License No. 9845. Carmel;' N:`Y
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' �• r,.•vY /G•,q, rhlLYitE�ft�n.d...._..;:..e s:L•:A } .
BRUCE R. FOLEY, R.S.
- - . • _ Acting Public: Health • Director
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
FORMAT (914) 278 -6130
NEIGHBOR NOTIFICATION
CONSTRUCTION PERMIT - DATE
RE: Department of Health Review of
Proposed Sewage Disposal System and/or Well
NAM E: b; Pe-4,1
ADDRESS: 4.t ke f'lkd@1
✓�
TAX MAP:
Dear. .17 r. 4bo4a- (7:4,e5 c&41 �% -dZ o,? 7 /
Please be advised that an application for a Construction Permit relative to the construction of a
ftvagevy and/or well proposed for the above captioned property has been made to the
Putnam County Department of Health. Attached please find a copy of the latest site plan.
Ifyou have any questions, concerns or information which may bear on the Health. Department's
review of this application, you may call Mr. Hedges of the Health Department at 278 -6130.
Very truly yours,
RECEIVED BY:
'j
ADDRESS:�G �i�J/i �y� '✓7 l/2�/ ,
TAX": I, 5f
BRF /JP
syswell
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BURGESS
Frig veer -Q- La-nd Si
Carmel,' N. Y.',*,:,,
DEPARTMENT OF HEALTH /
Division of Environmental Health Services /
4 Geneva Road, Brewster, New York 10509 d
(914) 278 -6130
APPLICATION TO CONSTRUCT A WATER WELL,>
PCHD PERMIT
WELL LOCATION
Street Address
492 Lakeshore
Town/Village/City Tax Grid Number
Drive, Putnam Valley, NY , 6—,Z -
WELL OWNER
Name Mailing Address
Don & Patricia Pearlstein, 60 Sutton Place So.,
OPrivate
NYC OPublic
USE OF WELL
1 - primary
2 - secondary
0 RESIDENTIAL
® BUSINESS
® INDUSTRIAL
0PUBLIC SUPPLY QAIR /COND /HEAT PUMP
O FARM O TEST /OBSERVATION
U INSTITUTIONAL O STAND -BY
13ABANDONED
O OTHER (specify'
AMOUNT OF USE
YIELD SOUGHT 5+ gpm /# PEOPLE SERVED /EST. OF DAILY USAGE gal
® REPLACE EXISTING SUPPLY ® TEST/ OBSERVATION CIADDITIONAL SUPPLY
O NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL
Existinc; well is under the house.
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
WELL TYPE
DRILLED
DRIVEN ®DUG OGRAVEL
OOTHER
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No.
WATER WELL CONTRACTOR: Name P.F. Beal & Sons, Inc. Address:4 Putnam Ave., Brewster, NS
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO PROPERTY FROM NEAREST 'WATER MAIN: "
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
O ON SEPARATE SHEET
2/24/97
date)
MalcoLn. TL. Beal, kJr.
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within
thirt;, (30) days of the completion of water well construction, the applicant 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 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 urface or groundwater.
Date of Issue: /�%jl -�— 19 .7
Date of Expiration T 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
3�
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RULD lot NO. 272
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FOUND
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PATIO GbTONf LAWN Y
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FILED LCT NO. 288 J Ju " 0� {CKETf N
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CERTIFIED T0: uav AaSrRA;r ca zo.
WSIOE
14011-UMV BANK
DATE suRUEYEO:
JME 23rd. 7001
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Co1NTY of Pun"
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C� LAND'
LO $
Lv. 269. 27. & 271
5::..� ot, Ne YO,ia
AREA CALCULATIONS SUMMARY
Coda Do-etson, . am, T.,ft. . I
Gm First Floor 2075.00
2075.00
TOTAL LIVABLE {rounded)
2075
4 Ames Total
LIVING AREA BREAKDOWN
smakaom
First
27.0 x 27.0
129.00
12.0 a 12.0
*44.00
.14.0 x 31.0
434.00
'12.0 3i
769'.06
4 Ames Total
Real Property Consultants
and Testiag'Sef0ces"
498 Horsepound Road
Carmel, New York 10512 Sanitary System Evaluation
Client Information:
Jeffrey Greenstein
5 Dianas Trail
Roslyn, New York 11576
TEL: 212- 979 -6400
Inspection Information:
492 Lakeshore Road
Putnam Valley, New York
Testing Date: 05 -11 -01
Testing Time: 4: PM
Point of dye placement: Toilet
Date of visual confirmation: 05 -12 -01
Time of confirmation: 7: AM
Test performed by:
JOSEPH CMAR
Witnessed by:
( ) Positive results ( dye observed leaching )
�(' /jq
CwNegative results ( no traces of dye observed ) operating satisfactory
(approximate location of system)
Note:
The septic dye test is an indication that
The disposal area was not leaching or
Saturated during the visual inspection.
This test is not a guarantee for the
Entire system...
. eo ++
&4v" w FtaAV.Lc :{
0 S, s H {vt AFI,.
9pi D ME INSPEXTOR
4/4
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t I -A
Terry Greenstein
Roslyn Estates, New York 11576
Putnam County Department of Health
1 Geneva Road
Brewster, New York 10509
February 28,2005
Re: 492 Lake Shore Road Putnam Valley New York
Dear Sirs/Madams:
Enclosed please find a Proposed Addition Application that I had been instructed to
submit in conjunction with a Variance Application that I am submitting to the Town of
Putnam Valley Zoning Board of Appeals.
The proposed addition to my home is a screened porch. I are not certain at this time if
there will be any windows, but want to keep this option open. I have been told that
because of the possibility of the use of windows, I will need your department's approval
to be submitted to the Zoning Board of Appeals.
I am submitting the Variance Application by March 2 in order to be eligible for a
hearing at the end of the month. I hope to get your approval as soon as possible so that I
can proceed with this schedule. I was told that my home might need an inspection. I will
be available Wednesday to Friday this week to accomplish this task as well as anytime
after this week. I will call to _follow_ up and to schedule a convenient time if it is
necessary: - - - . .. _ .... .... .._ _ �.. ..... _ ....... .... _ . ...... . .
The number of existing bedrooms in the house is currently 4, although only three are
being used as bedrooms (one as a den). The information from the building department
erroneously listed 3 bedrooms on record. I understand that this was a "guestimate; no one
had actually entered the house to count the rooms. I have informed the building inspector
of the error and it will be corrected. This information will be forwarded to you.
Please feel free to contact me at any time. My cell phone number is (516) 459 -7185.
My home phone and answering machine is (516) 484 -9524.
Thank you for your assistance.
Sincerely yours,
Terry Qreenstein
N
LORETTA MOLINARI
Public Health Director
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/Preschool (845) 278 - 6014 Fax (845)27$ - 6648
r
Putnam County Dept. of Health
1 Geneva Road
Brewster, NY 10509
To Whom It May Concern:
ROBERT J. BONDI
County Executive
Re: IS7 IJ %-r6 z
Residence
Tax Ma 4A G — 2 --" (,t-,
Town rJ /Vv. AL-L -'_I
According to records maintained by the Town, the above noted dwelling,
IS . _... q�...._ _.
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
houseguidelines
' 'LORETTA MOLINARI
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT J. BONDI
County Executive
Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 C
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLYI
STREET f 1 LQ4 S� bob- TOWN Aft, Vaal TX MAP #
NAME�eC�r +-�Cr _ `9Ydn PHONE M 8 5 PCHD_#
MAILING ADDRESS S p a no,'S T a'_�_- N N�� 76
DESCRIPTION OF ADDITION Steed- `�o�c
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 approval of plans (Construction,
Permit) prepared by a Professional Engineer or Registered Architect in accordance with
applicable sections of the Putnam.County S*tary-Code.
Please submit this form and the following to Putnam County Health Dept., 4 Geneva Rd.-,
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)
*
Non-professional. sketches are acceptable
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 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.
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
- — LORETTA MOLINARI; RN; MSN
Associate Commissioner of Health
Greenstein
5 Diana's Trail
Roslyn Estates, NY 11576
Dear Mr. & Mrs. Greenstein:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ROBERT J. BONDI
County Executive
March 8, 2005
Re: Addition — Greenstein, 492 Lake Shore Rd.
No Increases in Number of Bedrooms
(T) Putnam Valley, TM #41.6 -2 -6
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 March 7, 2005. The addition is approved with the following conditions.
1. The total number of bedrooms must remain at four without prior approval by this
Department.
2.—The areavof the-existing sewage disposal system, and- its-expansion 'area,,mustbe _.__._'_._t
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: Im
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