The URL can be used to link to this page

Home My WebLink About2419DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 50.16 -1 -13 BOX 21 02419 lir r NL ., iL , is WJL 11 r �' : • L ■ 02419 L u ._... BRUCE .:IL _.- ,F0LRY.;_- ....., 4 ..... , ,,....- Public Health Director DEPARTMENT 1 Geneva Brewster, New OF HEALTH Road York 10509 -LORBT —1 A MOLINARI -R.N.' 'M:S.M ' 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 June 18, 2002 Karolyn Stewart 43 Trail of the Hemlocks Putnam Valley, NY 10579 Re: Addition- Stewart - Trail of the Hemlocks No Increases in Number of Bedrooms (T) Putnam Valley Tax # 50.16 -1 -13 Dear Ms. Stewart: t 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. June 18, 2002 The addition is approved with the following conditions: 1. The total number of bedrooms must remain at ne 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. 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 your convenience. Very truly yours, Michael Luke Public Health Technician ML/ks cc:BI ,. ,6, ,,, v,� z , k , -y o � J�ti io VVI w.. u BRUCE R. FOLEY Public Health Director LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director , T ' " �' -' ►rector" of 'Pa�ierit 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 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014' Preschool (845) 278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLY) STREET y3 rh 6 rHeftd u c. ZOWN RAaW x MAP# 50-16-1-13 NAB HONE V-5-52L 0705 PCHD# / tf ej -0 MAILING ADDRESS _5',WL' DESCRIPTION OF ADDITION 3 .S IO R NUMBER OF EXISTING BEDROOMS __L_PROPOSED # OF BEDROOMS Z (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. submit this.form.and. the. following. to Putnam County Health Dept 4 Geneva Road,_Brewster, NY 10509; Ph6ne 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. OFFICE USE Comments Feb98 BFhouseguidelines c Y BRUCE R. FOLEY LORETTA MOLINARI R.N., M.S.N. Public Health Director Y �4 Associate Public Health Director 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 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: Re: C50, —/ Residence Tax Town 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 BFhouseguidelines Building Inspector Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York 10509 LbirE `FTA:- ,M0Lr11'AR1._R.,N-,- rvLS M . ;. 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 Preschool (845) 228 - 6108 Fax (845) 278 - 6648 Karalyn Stewart 43 Trail of Hemlocks Putnam Valley NY Re: Dear Ms. Stewart: August 6, 2001 Addition - Stewart - 43 Trail of Hemlocks (T) Putnam Valley Tax # 50.16 -1 -13 I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans indicate that the proposed addition will consist of the following: Two Story Addition Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: 1. The legal bedroom count for the dwelling is One. The potential bedroom count _ of your proposed addition is Iwo, 2. The addition of potential bedroom requires this Department's approval of a revised septic system plan from a professional engineer. Please revise the proposed floor plan the reflect no mote than One potential bedrooms, or have a professional engineer or registered architect design a sub - surface sewage treatment system meeting present code requirements. If you have any questions, please contact me at your convenience. ML:kg Very truly yo ""�iael Luke Public Health Technician ,: .7ZC 8E //V L G G. T i Plo LO 42 =LOr� In N -ENT/TL ED �Q �' Q •.� AKE O . ;/N MAP.°Y ;F /L ED 1,ev �� h0 p aCLERK:5 c 13N - i .�rq5 MA. /STY._; 106 CABIN OC 30 L 07 43 ---� -N 4 5 Z N 37.32 / \ jGD, a. L , 1 \ Y4E� /Sry AKE34 5, \ STAKE ac�a` Sr d 27 I 2 22. 0' . 337.2+ 32525 " Zp4 B 02.(90 L .77 102 L-0 % N 152.� Q F foR W nCH �A`l EY Y� i °4 M 5 - a 7 5 TN P B9 O STAKE Ii io THE �� 35 ytiT Fz DAD :. �coN�EyE� 5 55�a2 SURVEY OF PROPERTY Qk If ° PREPA RED FOR TO P OC�4A 02"' 0% U. AM'A SITUATE I/v -- TO WN. F PUTNy VA 1. ._ PUTNA/W COUNTY /VEkAv 5CAL E : / °= 20' DATE: Gershon Palevski, Architect 260 Canopus Hollow Road Putnam Valley, W 10579 Tel. 845.528.6073 Fax. 845.528.0409 June 12, 2002 Michael Luke Public Health Technician Department of Health 1 Geneva Road Brewster, NY, 10509 Re: Addition — Stewart — 43 Trail of Hemlocks (T) Putnam Valley Tax # 50.16 -1 -13 Dear Mr. Luke: We are resubmitting revised plans for proposed addition for Ms. Stewart. In the previous submission was unclear what kind of rooms are in the present structure. r._ . __ .. �.:, Actual )y,, existing_building- .doe$_not have_ any lives in a single room, which serves as living room and bedroom. The existing room in the basement is unheated, inhabitable space. The proposed house with new addition will have ONE bedroom. Please review new drawings and if you have any questions contact me at your earlier convenience. truly yours Gers on Palevs i Architect . o. —c41. �� ryl CW �►� [� �'`j� WL' LL l�Vl "1rLr,11V1V �rV�� DEPARTMENT OF HEALTH PUTNAM COUNTY DEPARTMENT OF HEALTH Office Use Only - WELL LOCATION STREET AOURESS. WN /vI 1 1 Y TAX GRIO NUMBER: If, s¢3 lI- o;` LaC � OWNER NA E: ADDRESS: NA E- 19 �J PUBLIC PueLtC USE OF WELL 1 - primary 2 - secondary fKRESIDENTIAL PUBLI SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED ❑ BUSINESS O FARM O TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT _. gpm. /N0. PEOPLE SERVED_/ EST. OF DAILY USAGE `fO gal. REASON FOR DRILLING' ❑ NEW SUPPLY ❑ PROVIDE ADDITIONAL SUPPLY ❑ TEST /OBSERVATION REPLACE EXISTING SUPPLY ❑ DEEPEN EXISTING WELL DEPTH DATA WELL DEPTH °� °T / ft. STATIC WATER LEVEL 30 r ft. DATE MEASURED 171h A DRILLING EQUIPMENT JS ROTARY ❑ COMPRESSED AIR PERCUSSION ❑ DUG ❑ WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify): WELL TYPE ❑ SCREENED O OPEN END CASING, OPEN HOLE IN BEDROCK ❑ OTHER TOTAL LENGTH '.2 ft- MATERIALS: ® STEEL ❑ PLASTIC ❑ OTHER CASING DETAILS LENGTH.BELOW GRADE 9 ft. JOINTS: ❑ WELDED CRTHREADED ❑ OTHER DIAMETER in. SEAL: ❑ CEMENT GROUT O BENTONITE ROTHER WEIGHT PER FOOT Ib. /ft. DRIVE SHOE &YES ❑ NO I UNER: OYES 9NO SCREEN DETAILS- - - DIAMETER (in) SLOT SIZE LENGTH (ft) DEPTH TO SCREEN (ft) DEVELOPED? FIRST - :....:.. _ _... - .._ �..... _. . :...:...�- :.:..::OYES 'O_:NO_ -..., HOURS SECOND GRAVEL PACK O YES O NO GRAVEL SIZE: DIAMETER OF PACK in. TOP DEPTH ft. BOTTOM OEM It. WELL YIELD TEST tf detailed pumping RCHOD: O PUMPED tests were done is in- OMP AIR , formation attached? BAILED O OTHER ' ❑ YES ❑ NO it more detailed formation descriptions or sieve analyses WELL LOG are available, please attach. DEPTH FROM SURFACE water Bear- ing We1l Oia- meter FORMATION DESCRIPTION COoE. ft. ft WELL DEPTH ft. DURATION hr. min. DRAWOOWN It. YIELD gpm. Surface 7� WATER X CLEAR TEMP. QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? YES ONO ANALYSIS ATTACHED? VYES O NO STORAGE TANK: TYPE CAPACITY GAL. PUMP IMF RMATION / TYPE 3 CAPACITY �� J MAK DEP H �� Moo �'" VOLTAGa HP WELL DRILLER DRIER NAME OAT ADDIiE ��IGfrkiURE 7 7. 011 984 � Yorktow�l Medical Laboratory, Inc. LAB # _ 321 Kear Street Date Taken: Time: York t9wn„HeightA JYI Y..10598. _ _,.� .,..-Date Rc' d: (914) 245 -2800 _ Date Reported. - ^ " Director: Albert H. Padovani M. T. (AXP) Collected B.y : f %��✓,p�e�- Referred By: Sample Location:c� Gc, �f 3 Tk 4-/L Or- M�� .� s . Phone # - b -704 Phone # Sample Type: L ,j Repeat Test? — (check each) LABORATORY REPORT ON THE QUALITY OF WATER INORGANIC NON- METALS (mg/L) MICROBIOLOGICAL CFU /100mL Acidity _ Alkalinity _ Chloride Detergents, MBAS _ Hardness, Total _ Nitrogen, Ammonia _ Nitrogen, Nitrate _._ Phosphate, Total _.Sulfate _ Sulfide Sulfite METALS �:.ti: /L) Copper Iron _ Manganese Mercury Sodium Zinc MISCELLANEOUS pH (units) _ Color (units) Odor (TON) Turbidity (NTU) GENERAL BACTERIA Standard Plate Count (CFU /1.OmL) MEMBRANE FILTRATION TECHNIQUE V Total Coliform 4 Fecal Coliform _ Fecal Streptococcus. MOST PROBABLE NUMBER TECHNIQUE Total Coliform Index _ Fecal Coliform Index KEY FOR TERMINOLOGY CFU = Colony Forming Units CON = Confluent (q.v. TNTC) LT = C = Less Than GT = > = Greater Than N/A = Not Applicable S/A = See Attached TNTC= Too Numerous To Count REMARKS /COMMENTS (For Lab Use) !/ Potable Non- potable STP INF STP EFF Other: Sample Status: (check each) Outgoing HNO3 _ HC1 _ H2SO4 NaOH ZnOAc _ Na2S203 Other: Incoming ��- _ LE 40c _ G 400 pH LE 2 — pH GE 9 pH GE 12 Other: ELAP No. 10323 THESE RESULTS INDICATE THAT THE WATER SAMPLE (Was)' (Wasn't) (N /A) OF A SATISFACTORY SANITARY QUALITY ACCORDING TO THE YORK STATE PUBLIC DRINKING WATER CODES, FOR THE PARAMETERS TESTED, AT THE TIME OF SAMPLE COLLECTION. THESE RESULTS INDICATE THAT THE WATER SAMPLE (Did) (Didn't) N. /.. MEET THE SATISFACTORY CHEMICAL QUALITY STANDARDS OF THE NEW YORK PUBLIC D NG WATER CODES, FOR THE PARAMETERS TESTED, AT THE.TIME OF SAMPLE COLLECTION. Ix/ v Albert H. Padovan .T. (ASCP), Director 2 /86(Rvsd7 /87)RWE DEPARTMENT OF HEALTH Division of Environmental Health Services 11 LD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 'APPIGT'CAt.�ON' °Tl0 CONSTRCTCT':A`Sn1RTE'�`WELL "" -" ' ° PCHD PERMIT #W_1__01 WELL LOCATION Street Address To Vil 41 g City Tax Grid Number WELL OWNER Name "nAddress 5-'e �i rivate 0 Public USE OF WELL 1 - primary 2 - secondary RESIDENTIAL ® PUBL C SUPPLY 0 BUSINESS O FARM ® INDUSTRIAL O INSTITUTIONAL O AIR /COND /HEAT PUMP O TEST /OBSERVATION O STAND -BY 0 ABANDONED O OTHER (specify AMOUNT OF USE YIELD SOUGHT rpm /�� PROPLE SERVED d /EST. OF DAILY USAGE 500 gal REPLACE EXISTING SUPPLY ® TEST /OBSERVATION GI ADDITIONAL SUPPLY O NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED ®DRIVEN ODUG ®GRAVEL. OOTHER IS WELL SITE SUBJECT TO FLOODING? YES �NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: 5� Lot No. 4.. WATER WELL CONTRACTOR: NameA%QR%Y)iM /4N G Address: A!$-pe6 &-R IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _A_NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY 'DISTANCE__TO-PROPERTi FROM NEAREST -WATER--MAIN,:.- LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED 6j/ / J OON SEPARATE SHEET (date) ignature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted tinder 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 s.hall: 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 Putna County Health Department. Date of Issue: 1444it 19� "`� y Date of Expiration: 19 .576 ermr_ ssuing OffiPal White copy: H.D. File Permit is Non - Transferrable White Yellow copy: Building Inspector Rev. 10/88 Pink Copy: Owner Orange copy: Well Driller y�w�.. 4...yq..f,a.�•...:.i'9,+a,•'A'u Y...,t+.q....: a`: �'.. i "..:... ♦-�i -..t. ..._ .. . - MARVIN O'DELL Inspector TOWN OF PUTNAM VALLEY BUILDING, ZONING, AND SANITARY DEPARTMENT March 6, 1989 Department of Environmental Health 110 Old Route 6 Carmel, N.Y. 10512 Re: Proposed Well- PV TM #24 -3 -2 & 3 K. Stewart Gentlemen: TOW.N... HALL.. . PUTNAM VALLEY, N.Y. (914) 526 2377 The proposed Water Well site as shown on the attached drawing was inspected on 3/3/89 , and as could be determined was found to be a minimum of one hundred (100') feet from any reported sub - surface sewage disposal area. Applicants that receive permits shall upon completion of construction, submit to the Town of Putnam Valley (Building Department)a copy of the well drillers Log and.Water analysis report- before said well,-is.•put-. in service. C;' MARVIN O'DgXL Building Inspector MO'D:es Jv' ^ - - � s A :7 �` l�� Z %F / �0 �' ,: ,o . O PR' EA415E o � � � � 8,EIAIG LC sPl LOT 4t2 LOT42_5 �w �- ENT /TL EO /N HAPPY F//- ED /N A5 MAP. r W 9 �. 4 / i srr. CERT /F /E COMNIO/` "IAISURA /I 4,0 4'3 0,.E LOT ' �.3. / NEYV YD! 3,. Zoe. �I t j 3620. 0 337 O A; 224 � . I �� \ p�JRpOBO�. L= 34 2 7' y '�. B59` rvA'� 22' r! ,Q: 325.9 r. --�. 5 Q7 R f/IG �_- �� r� � yr; Uv`� -� �7 FoR f.-ti ;..�! /� fr �� S 5��P2rNe9 v ' O•, SrAXe sofp I86 : . '. �o To �,e �� 3s�-/0" riT R °A° :: � � r SURVEY OF PROPERTY r coN` ey S 55- PREPARED FOR o AMA S /TUATE IN F PUTNAM VA L PU TNA M PREP Y � . � - �•._ � - -.. . _ .. COUNTY tl / I / tl L... fl V' R SUNNEY /EYOR. P.C. SCALE: 1"=20' DATE: AUGUST RIDGE ROAD /�E S,EQ W YORK 10536 r DEPARTMENT OF HEALTH Division of Environmental Health Services LD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 T.O....CONST:RUCT.. -A. _WATER P'CHD 'PERMIT < #W -/ WELL LOCATION Street Address To Vil y �3 / �f�tLvc g City Tax Grid Number --3 WELL OWNER Name sf� .t! bWlin Add�jess P/�2C� G V • '7 O rivate O Public USE OF WELL 1 - primary 2- secondary RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL 0 PUBLIC SUPPLY Q AIR /COND /HEAT PUMP 0 FARM O TEST /OBSERVATION 0 INSTITUTIONAL 0 STAND -BY 0 ABANDONED 0 OTHER .(specify, O AMOUNT OF USE YIELD SOUGHT_,'5" gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGE 500 gal REPLACE EXISTING SUPPLY 0 TEST /OBSERVATION 12. ADDITIONAL SUPPLY 0 NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR 'DRILLING WELL TYPE �( DRILLED DRIVEN EIDUG GRAVEL. OTHER IS WELL SITE SUBJECT TO FLOODING? YES X_NO -IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: SLilVAU Lot No. 4.2 WATER WELL CONTRACTOR: Name.A10R17)1gAf 14Al dS(� Address : �-ja 6 &V IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES __A_NO NAME OF PUBLIC WATER SUPPLY: _ TOWN /VIL /CITY �^ DISTANCE. TO PROPERTX FROM _NEAREST WATER. MAIN:. LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED DON SEPARATE SHEET _ (date) / C ` ignature) 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 s.hall: 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. Date of Issue: 19 Date of Expiration: 19 Permit is Non - Transferrable Rev. 10/88 Permit Issuing Official White copy: H.D. File Yellow copy: Building Inspector Pink Copy: Owner Orange copy: Well Driller PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 February 15, 1989 ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. Director Ms. Karolyn Stewart RD 4 43 Trail of Hemlocks Putnam Valley, NY. 10579 Re: Proposed Well Dear Ms. Stewart: Please find enclosed your application to construct a water well. This application must be submitted to Putnam Valley's Building Inspector, Marvin Odell, prior to the review by this Department. Only after Mr. Odell's written comments are received by this office can the approval process continue. Upon receipt of a submission revised to reflect the above comments, this application will be considered further. Very truly-yours , Lawrence C. Werper BF•LCW•jr Assistant Public Health Engineer CC - lam "VVZ: / DEPARTMENT OF HEALTH y� Division of Environmental Health Services 11 LD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 _ _..........APPLICATION.:_T.O. _CON.ST UCT.. • -._.. �.�... y ,.., �. :,A PCHD' PERMIT..� #�l�L�� / WELL LOCATION Street Address Town /Vil Rb y 1/ m/— vepavrj l.0 cl g City Tax ,v Grid Number - 3 3 WELL OWNER Name Add� jess S�'E tJ �"n V• rivate ❑Public USE OF WELL 1 - primary 2 - secondary RESIDENTIAL ❑ PUBL C SUPPLY ❑ AIR /COND /HEAT PUMP 0 BUSINESS O FARM ❑ TEST /OBSERVATION 0 INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY Q ABANDONED O OTHER (specify 0 AMOUNT OF USE YIELD SOUGHT�gpm /# PEOPLE SERVED_ /EST. OF DAILY USAGE JroO gal REASON FOR DRILLING REPLACE EXISTING SUPPLY ❑ TEST/ OBSERVATION GIADDITIONAL SUPPLY ❑ NEW SUPPLY NEW DWELLING C! DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN []DUG D GRAVED OTHER IS WELL SITE SUBJECT TO FLOODING? YES _X NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: S(j Lot No. WATER WELL CONTRACTOR: NameA10R 1g1t1 /4-n1 deLz- & Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES > NO NAME OF PUBLIC WATER SUPPLY: — TOWN /VIL /CITY .DISTANCE_TO_PROPERTY :: FROM. NZAREST :_WATER, MAIN.:—: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED []ON SEPARATE SHEET (date) ignature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted Dnder 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 s.hall: 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. Date of Issue: Date of Expiration: Permit is Non - Transferrable Rev. 10/88 19 19 Permit Issuing Official White copy: H.D. File Yellow copy: Building Inspector Pink Copy: Owner Orange copy: Well Driller �rn 5 7 Po LOT 42 �� v ® 'i Lor42L5 � ti N jt ENTITLED 51AKE . Q • /N NAPPY fI�e cC2 v F /LED /N CLERK S A h0 ; . p X�a A5 MAP = u: Cll co wl EFRT /F /E � Lod CABIN" COMMOn per• y � _ ,. �....� _�;,�' r�:.l� - . _ , . ..._. -. - _ .... _.- /VEtN... YOi N 543 32" oy5 � \ ,., � 36.2• Vz 14 EL� /sTr "' / KE \ 57-AKf srA _ 25 cog�M 0 337.27• J ` 6� s, ' I pp5 Ei 5" � 22 e ` PLJ 2 .BO L = 34.2 5 .77' .� � � �tinL� � � f.V - � N�Gr!A� � Z � f ...' � All _ . 52 Y FpR TDR i uC� v _ u, 042- /O" VAL �! � i i� ,s 1-� �" "-7-I VA O S7-,4 0a ,6 a.18 / t:. . t0 54 ! AD -/ � 3 O �l � ro rN E (� a -/o ri R :� _ �. SURVEY OF PROPERTY D CONdEyE 5 55 a2 �-� PREPARED FOf? �o RICHARD. U. AMA S/TLIA7 E IN a NAM VA I �. PUTNAM COUNTY NEW PREPARED BY - / , .. y.d,{ •j ^t / R BUNNEY 'EYOR. P.C. SCALE 20' RIDGE ROAD " N YORK 10536 DATE: AUGUST FrE V /SAO ' SEPT' G RA t L 1//2 c.LfiwFg -m l/ ;J 0 ,a O PREA4152 BEING LC -Z �� Plo LOT 42 �� cb > r �OT42_ O s� ENT /TL EG �, �E .. O /N HAPPY 2e C C,' �' / - STP FLED IN / `- CLERK S '. AS MAP CERTIFY ' COMMOI 10d C1B /N' t INSURAI 3 „ L OT' 43. j 36-2 0' R Z : rAK 5rsIKE O Cq j X24 y s.v'e ` P�RPO�Q G- 34 - 7' V _ 152 ° pv:. `LAY FOR �.� :i A4 L pC CS 5� °421 NAM : ✓AY ' O KE �pP ,.SrA TO�Na ROAD ..-: i p ro rNE ��2./o S U!-�VEY OF PROPERTY CON �Ey 5 55 �� 'I PREPARED FOR RICHARD- %J, 'AMA / O S /TUATE W 9 �. TOWN OF PUT'N.4 M VA L TRH` - - PUTNA, M COUNTY NEW PREPARED BY _ - . •- •ie' : ^n -. s :R BUNNE.Y ... _....: , 1 / DATE: AUGUST VEYOR. P.C. - - •• - iRIDGE ROAD :W YORK 10536 u AV860,1 1,50" F� L it :.i I I 1 / I � j 1 o f i P/O LOT 42 19- Ot< //� F' w �m 0 AV ?26 / / 29' a 112" 1 SEXIST. 1 /. :1 STY ` N54d- o4 — "30 "E LOT 43 O40p LOgCABIN 1 37.32' P6 s4°` 1 1 1 Z 'al F CO Gcge /N ' 1 0 1 M s l 2 .80' �� - L= 34_25' - -� - - 337.27 1 - R= oI - - - - - - 175.47' „� FtE HIGHWAY VAi l c`t' Fv t Fl, ..., S S PCRPO�^ 22-80, -� L= 34.'25' R 32 5.77_---------- 3556_42 UTN - - - _ r OF - -, i -- - _- - - - - -- i � THETOWN _ _ CONVEYED TO _ - a�5 47 - - -- '" - - �- � ` 1 _ ROAD -- --" - -