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Home My WebLink About2303DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.10 -1 -23 BOX 20 Fro We a LIN L NJ r 02303 Date :4>.St a � c' 2; 95%2 t ...... TOWN OF PUTNAM VALLEY > Application No:�� : . r'.. 0 ---- IAPPLICATION FOR BUILDING PERMIT. Zone District . pp� Application is hereby made to erect (alter) .... • • • • • •Work to start ...... :I Building ... .....O!f' ~...�.��'...�l !!✓� ...................�. �.............. . Location of Premises — Street or Road .... q�r,= ........=", Ro.4.17• ..... .. • . • . • • . • • • • • • SEC............ BLOCK ........... LOT 1f. . .6.... FRONTAGE ... .... Depth ......... Rear......... . ACRES (other description) or number of square feet ................... ........ ..: !• .. � OWN ERl% !�.f% o7.� �L!..................... ADDRESS 'Pa.. Dimension of Building TOWN OF PUTNAM VALLEY, Putnam County, New York, Width De th Stories 83 =0 �s'o a..-a. x x x x X x x x Type foundation ppat ....'. Size & use each ......� .. . Room with window area .9........d. .................. Sewerage type ................... Size of septic tank ............... Lineal Ft. Drainage .............. X ENCL. I ELECTRIC Size of dry wells ................. Pursuant to a Sanitary Code of the . above Town, the install one. ,,,G�v! .� 3L.107 Name of owner.. p P. O. Address.. _ ......:.. ................. pc,�.....�....�SPACE ..... . Location .... ..... I ............. Block No............................................... ... ......... . ....... .................•`.��. ................... FOR Lot No...... ........ Application N? 1145 Date Z............. ,g CIA, undersigned hereby makes APPLICATION to Area of Land ...................................... Acres...................... Sq. Ft. SKETCH ............ Maximum No. of people expected to use facility...... 49 .x............ Date installation will be staited,, NOTICE: A BLUE PRINT OR SKETCH showing (1) boundary lines of property (2) -wells, cisterns, springs, etc. (4) proposed location of facility, including drains, THIS APPLICATION: EL/ L-i buildings (3) lakes, streams, MUST BE FILED WITH Name of Plumber .... . ........ 9c- r ��. - �-�.......:..`-- ....:. P. O. Address ........................... r.. ............................... Signature of Applicant........... ....... REMARKS.......................................... ............................... .................................................................................................................. ..................:............ ------------------------------------------ I CONSTRUCTION I ROOFING I LAND ILY I' WOOD WOOD SHINGLE PAVED ILY STEEL ASB. SHINGLE RT ABIN BRICK• TILE OILED ALOW CONCRETE TIETAL SWAMP JUSE TMENT STONE BROOE FN DTNS. INTERIOR I LAKE F. E & APT. STONE ROOMS I DAMS E & OFFCCONCRETE APT, ROOMB SW. POOLS E P BLOCKS I APT. I TEN. COURTS GAS STATION BRICK I{ ATTIC OPEN GARAGE PIERS I FINISHED OTHER BLDG& EXT. WALLS I PORCHES BARNS BASEMENT WOOD x" FRONT I SHACKS PART BRICK A SIDE I COTTAGES L FULL BRICK VAN. s REAR BUNGALOWS _ EMENT_ FLOOR TOWN OF PUTNAM VALLEY, Putnam County, New York, Width De th Stories 83 =0 �s'o a..-a. x x x x X x x x Type foundation ppat ....'. Size & use each ......� .. . Room with window area .9........d. .................. Sewerage type ................... Size of septic tank ............... Lineal Ft. Drainage .............. X ENCL. I ELECTRIC Size of dry wells ................. Pursuant to a Sanitary Code of the . above Town, the install one. ,,,G�v! .� 3L.107 Name of owner.. p P. O. Address.. _ ......:.. ................. pc,�.....�....�SPACE ..... . Location .... ..... I ............. Block No............................................... ... ......... . ....... .................•`.��. ................... FOR Lot No...... ........ Application N? 1145 Date Z............. ,g CIA, undersigned hereby makes APPLICATION to Area of Land ...................................... Acres...................... Sq. Ft. SKETCH ............ Maximum No. of people expected to use facility...... 49 .x............ Date installation will be staited,, NOTICE: A BLUE PRINT OR SKETCH showing (1) boundary lines of property (2) -wells, cisterns, springs, etc. (4) proposed location of facility, including drains, THIS APPLICATION: EL/ L-i buildings (3) lakes, streams, MUST BE FILED WITH Name of Plumber .... . ........ 9c- r ��. - �-�.......:..`-- ....:. P. O. Address ........................... r.. ............................... Signature of Applicant........... ....... REMARKS.......................................... ............................... .................................................................................................................. ..................:............ ------------------------------------------ e z #�w, +-. •, ra c;r ", ivl2 Application for Building Permit Application Plan File No.......... TOWN, OF PUTNAM VALLEY : Zoning District.. ..l ................ NAME of Owner......... d 1. P. 0......... ....... ...... i LOCATION of Premises: Street or Road ... . ._�. / -... ......... Block No...... Lots No.'` lO Side of Street.... ...... ....... LAND: Number of Acres ........................................ or — Number of Square Feet .................................... In feet show: Frontage .................................... Depth ...------ ••---- ....._•- • -_.... Rear .............................. Otherdescription ......... ...............••- •----- ........ •--•----...-----...-----...............-----•----••------ .._.........._-- •- •- •--- _..... BUILDING: to nearest foot show: Overall width....8� :�?...., Depth .... 4 '7�0 Heignt...fa.�' :�.... _.__Type of building Kind of Foundation ___•••-- -------------------------- Show size and use of each room, together with window area .................................................. SEWAGE: Type_ .................... Size of Septic -Tank ........ AO "o ............. gallons ................................ Lineal feet of field drainage ............... A1.?:!5� ................. Size of dry wells -------------------------------------- Building permit issued and fee paid ...... ei0."f.�_ �.`�__ 3.� ........................ Fee paid for .Certificate of Occupancy .... ........................................................................................ Occupancy Inspection made ...................... ....... ................................................................................. Certificate of Occu ' sued.. - - - - =• • -- -•- •- - - - -•• -------------------- SIGNATURE of Applicant - - '.. °.� ..... 0 ------------------------------------------------------------- RECEIVED ............................................. 195 UNLESS THIS APPLICATION IS ACCOMPANIED BY A COPY OF A SURVEYOR'S MAP AND COMPLETE PLANS AND SPECIFICATIONS, ALL INFORMATION REQUIRED BY THE ZONINCr ORDINANCE AND SAN- ITARY CODE MUST BE SHOWN BELOW OR ON 7HE REVERSE SIDE OF THIS APPLICATION. ^_r June e-mail printed Wed, 29 Aug 200109:30:25, page 1 Prom: <CCQmapmobile.com> To: Undisclosed - recipients:; Date: Tue, 28 Aug 2001 17:03:56 -0400 (EST) P/C MYRON WSINICK 212- 799 -0688 RE: CAN CALL & LET US KNW WHEN THE PUMP IS IN & HOW MUCH IT COST 6- IN '.4 �� I r- JU11V V--IIIGII PII[Imu VVCU, zw /1Uq LVV 1 VmJV.40 , page 1 From: <CC @mapmobile.com> To: Undisclosed- recipients:; Date: Tue, 28 Aug 2001 17:03.56 -0400 (EST) P/C MYRON WEINICK 212- 799 -0688 RE: CAN CALL & LET US KNW WHEN THE PUMP IS IN 81 HOW MUCH IT COST C E4 ` rRaQ 1 / PUTNAM COUNTY DEPARTMENT OF HEALTH .DIVISION OF ENVIRONMENTAL HEALTH SERVICES v�Ia APPLICATION TO CONSTRUCT A WATER WELL please print or type PCHD Permit Well Location: 'e Address: / ?i- wn/Villa ,Tax Grid # - . JUyi� Map , %Block t(s) -� X Well Owner: N�ie� // Addr s: Use of Well: ResideMal Public Supply Air /Cond/Heat Pump 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 ry cD gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason - for Drilling Well Type Drilled C3 Oriven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No X Is well located in a realty subdivision? ...................................... ............................... Yes No X Name of subdivision Lot No. Water Well Contractor: Address: �! y Is Public Water Supply available to site? ............................... ............................... Yes 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 sheet/plan. Date: a i Applicant Signature: 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 Department. During all well drilling operations, the applicant and/or well driller shall 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 Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller cei if d by Putnam County. Date of Issue _qlillol I Permit Issuin Official: Date of Expiration I I IR46_35 Title: Permit is Non- Transferra e White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 h� PUTNAM COUNTY (DEPARTMENT OF HEALTH (DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Well Location Street ss: n/Villag :1-046 Tax Grid # Map , /QBlock % Lot(s) �3 Well Owner: Name: / Address: Use of Well: 1- primary 2- secondary Residential Public Supply Air cond /heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby Drilling Equipment Z Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing �L Open hole in bedrock Other Casing Details Total length 3 ft. Length below grade o2- P Diameter in. Weight per foot lb /ft. Materials: ?!�_ Steel _ Plastic _ Other Joints: Welded 20hreaded Other Seal: Cement grout _ Bentonite Other Drive shoe:.,:' :Yes No Liner: Yes o Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Test _ Bailed _Pumped X Compressed Air Hours Yield /Ofi gpm Depth Data Measure from land surface- static (speci ft) During yield test(ft) Depth of completed well in feet Well Log If more detailed information descriptions or sieve analyses are - available, please attac` r 4,7 r: p •. I• • • . Postage $ SdSll �} } 1 Certlged Fee V ofnestic mail Postmark I Return Receipt Fee Here idoreement Required) ° d3s ;, � estricted Delivery Fee 1 Er ndorsement Required)'l •� L r�� ti btel Postage &Fees 1 e y � N Postage ..t ZT� p Certified Fee teat, A ! or or P ox No. � ' _ -- tU Return Receipt Fee �' ( Endorsement Required) .......... .... o -�.... �_ State, ZIP+ �. ® Delivery Fee tY / U Restricted emend ReOra4l i Total Postage S Fees C3 M S n?tTO ��?reAPL No:; or Pt E=l / C3 CI ��. , N 9' �IU Postage $ „� Er 1 � Certified Fee ��,� � 1�!�y Retum Receipt Fee 61G�+ (Endorsement Required) p . Restricted Delivery Fee :p (Endorsement Required) 0 Total Postage r£ Fee's ;m. oS �L11 SenfTo r•a ?p Street, -A t No. or P o .- lyZ�,�a.. -. Irr-3 city, State, ZIP+ rr�