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HomeMy WebLinkAbout2524DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 51.18 -1 -1 BOX 22 11 1 INN% , I INN f- 6 16p ., skii IN 6 6t ?� or :i� 1 1219 "L I 02 524 I., BRUCE R. FOLEY, R.c Acting Public Health Oire DEPART:ti4E \T OF HEALTH Division Of Environmental Health Services Geneva Road, 6revrter, New York 10509 (91") 278 -6130 R,RQPCS- =Q AD`DITIO,�; APP: ICATIC?; _ (RESIDENTIAL ONLY) S ; __T �}3 / (fie / WlaW T 0 �, i NRL &%n kdl- 44M TX K J�[�,,22 C1� 1 jY j�z,/i�?5 P; ;0 \���ZCJfD ` PCND PERMIT r 9 0 ADDRESS Description of Addition N,--ber of existing be..ro - -:s 1�7 Proposed number of bedroons f rom. Certificate of Occupancy or Certification from Building Inspector �:-:y addition which is considered a bedre•cm re;uires formal approval of plans (Construction Permit) prepared by a Professional Engineer or Registered Architect 4r1 accordance with ap?lic=_ble sections of the Putnam County Sanitary Code. Please submit this fora and the followir,_ to PJfK -A%M COUNf y HEALTH DEPAFITMEW, _.......,.. 4 G =VA RO,D, BREVSTER, N; 10509,- Pl:on_ 278- 5130-with tne,follow.ing--in-formaLion. 1. Certified Check for $100.00. 2. Sketch of existing floor plan (all living area including basement, if any) Non- professional drawing is acceptable. 3. Sketch of proposed floor plan . Non professional drawing is acceptable" 4. Copy of survey shorting 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 questions please contact this office. .�- 5. Copy of Certificate of Occupancy from Tarn or Certification from Building Department of legal bedroom count of duelling. OFFICE USE Cornents and /or conditions application August 1995 July 1996 (Revised) DEPARTMENT OF HEALTH. Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 March 17, 1998 Jack Adams 43 Pine Hollow Road Putnam Valley NY 10579 Re: Addition - Adams, Pine Hollow Road No Increase in Number of Bedrooms (T) Putnam Valley TM #51.18 -1 -1 Dear Mr. Adams: BRUCE R. FOLEY 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 March 16, 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 three 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. Approval is granted for sewage disposal only. 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 ML:tn Public Health Technician cc: BI (T) 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, MY 10509 Re: Residence q -6 Tax Map Town Gentlemen: BRUCE R. FOLEY, R.S. Acting Public Health Director According to records maintained by the Town, the above noted dwelling V/ IS NOT in co pp * nce 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 Inspect DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 :.- .AuFLICA`'I'I NI TO 'CGIdSiRu °i . niAfiER � dE1�I;` ...;.. -...- 1a...- PCHD PERMIT # WELL LOCATION S reet Address own Vill aj t E �000 R ., ge City Tax Grid Number -S- II WELL OWNER Nam _ T1 I A Mailing Address V Private O Public USE OF WELL 1 - primary 2 - secondary URESIDENTIAL ® BUSINESS ® INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP ® ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify O INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT _5 gpm /# PEOPLE SERVED_ - � /EST. O REPLACE EXISTING SUPPLY ® TEST /OBSERVATION O NEW SUPPLY NEW DWELLING WDEEPEN EXISTING WELL OF DAILY USAGE 1 13 ADDITIONAL SUPPLY REASON FOR DRILLING DETAILED REASON FOR DRILLING ZLFON o ' 4- rw4s 'f WELL TYPE WDRILLED O DRIVEN ODUG O GRAVEL O OTHER 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 ' o C mfrs Win Sin Address: Sr • \T IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES V/ NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY. FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED []ON SEPARATE SHEET g ,�- (date)'(signature) 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 contaminate surface or groundwater. Date of Issue: ,iii 19 <�P'22 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 Inspector TOWN HALL VALLEY. N.Y. ,... -.. (914) 526 2377 ; TOWN OF PUTNAM VALLEY Grp- -2p BUILDING,- ZONING, AND SANITARY DEPARTMENT Date: May 81 1990 A { Putnam County Health Dept, 110 Old Route Six Center Carmel, N.Y. 10512 Att: Wm. Hedges, Health Sanitarian Re: Peyser - Northview Est. TM# PV- 26 -5 -11 Dear Mr. Hedges: The proposal to redrill a water well on the above noted property has been reviewed and approved by this department. Very truly yours, r ! �Ct, ✓� MARVIN 0 DEL Building & Zoning Inspector , MO'D:es o IZ NN Py 1 lam• r \` I INN ems- �� �, \\