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HomeMy WebLinkAbout2845DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.10 -1 -351 36 & 37 BOX 24 rm Lj A �. ., 02845 d DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 - +re> ... '1 Ti ':'• :ii'T,/��+,� ":1a T,TC'�T —TT11: Ti R,:, `;1. ''((A iT1 i �. P .. '. .c: cy Y -� >�.-a. s• .._ __ �. ... _:: _ PCHD PERMIT WELL LOCATION j,�tre t dress o To i la a Cyy Tax Grid Number r WELL OWNER =X-4_rC_- , ing Address u c. [Private O Public USE OF WELL 1 - primary 2- secondary RESIDENTIAL ❑ PUBLIC SUPPLY 0 BUSINESS O FARM 0 INDUSTRIAL O INSTITUTIONAL O AIR /COND /HEAT PUMP 0 ABANDONED O TEST /OBSERVATION O OTHER (specify, O STAND -BY O AMOUNT OF USE YIELD SOUGHT_ gpm/ # PEOPLE SERVED ----/EST. OF DAILY USAGE =ro a gal REASON FOR DRILLING ❑ REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION ADDITIONAL SUPPLY O NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING --- 61 Z7 WELL TYPE UMDRILLED DRIVEN DDUG GRAVEL 0 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: Nameo004 _C Address:- IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _�NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPEURT° FROM INE kRES'T WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET (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 thirt3, (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 any and all water or waste products from such well property and in such a manner as not to degrade or Date of Issue: l2 - 19 Date of Expiration ( 19 Permit is Non - Transfer able White 3/89 shall take appropriate action to assure that drillin operations be contained on this other is ontaminata surface or groundwater. Permit Issuing Official copy: HD File Pink copy,:...'Owner. Yellow copy: B1dg.'Insp. Orangee�-copy;:.Well Driller, ALLEN BEALS, M.D., J.D. Commissioner of Health ROSERT MORRIS, P.E., MPH Director ofEnvironmental Health DEPARTMENT OF HEALTH 1 Geneva Road,. Brewster, New York 10509. Phone # (845) 808 -1390 Fax # (845) 2787921 December 4; 2014 Mr. & Mrs. Kenneth Silverman 170 West Shore Drive Putnam Valley, NY 10579 Dear Mr. & .Mrs. Silverman: MARYELLEN ODELL County Execufiie Re: Addition— A- 166 -14 No Increase in Number of Bedrooms 170 West Shore Drive (T) Putnam Valley, T.M. 62.10 -1 -35, 36; 37 This Department has 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 December 4, 2014. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at four without prior approval by this Department. r 2.— The The area of the existng 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 ... 4. The approval is _for the modifications only and does not validate any construction shown as existing that has not obtained proper approvals from other agencies having jurisdiction. 5. This approval is valid for two (2) years and expires on December 4, 2016. Any permits or variances required under the jurisdiction of the Town of Putnam Valley are the responsibility of the applicant. If you have any questions, please contact me at (845) 808 -1390 ext. 43261. Respectfully, Gene D. Reed Principal Engineering Aide GDR:cml cc: BI (T) Putnam Valley ALLEN BEALS, M.D., S.D. Commissioner ofXealth Director ofEnvironmental Health V. CDARYELLEN ODELL County Executive DEPARTMENT OF HEALTH Geneva Road, Brewsier, New York 10509 Phone # (845) 8084390 Fax # (845) 278 -7921 ADDITION APPLICA'T'ION RESIDENTIAL ONLY STREET 170 W EST 51400E DWI V E TOWN PU TtJ AM V,ALI fTAX MAP # &Z- 10- i -:35,3 137 NAME 6fZtiM i5LL/ 51 W62MA.t -1 PHONE`3 i 4 )416)-& 310 PCHD #zj_4166:` -1�� MAILING M2 4 AA 25 - V_ ENNC-TH 5t L, .V60AAA s ADDRESS 170 Vu EST- 51402E 01z►V15, PuTNb -M VAL1JFY, N.4• 1 DESCRIPTION OF ADDITION t44-ADj>rno0 ►a BaseME��,%ifzsTLir•� S�caNi� F(ao2S *NUMBER OF EXISTING BEDROOMS -4 NUMBER OF PROPOSED NEW BEDROOMS 4 * (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., 1 Geneva Rd, _ i3rewster9 iv iv5vy;'rnorie. 1. Certified check or money order for $100.00. 2. Sketches of existing floor plan (drawn to scale, all living area including basement, to be shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin HA -1) 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) * Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin HA -1) 4. Copy of survey showing all well and septic locations on the subject property to the best of your knowledge. Include date of installation known. Contact this office with any questions. 5. Copy of Certificate of Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling. OFFICE USE CONMNTS 4. ALLEN BEALS, M.D., J.D. Commissioner of Health ,R,0_13 ±'•-RT MO RCS P �' Director of Environmental Health d MA.RYELLEN ODELL County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Phone # (845) 808 -1390 Fax # (845) 278 -7921 Town Legal Bedroom Count & Proposed Addition Status Re: D(ZU � L,(- 1:5 L vE(yRA (Owner's Name) Tax Map # &-Z, 1 o I 35, 3C,, , 37 Address: 110 W E-5'C Soo 26 D 2 ( V j5 Town: P q -r t,3ANt VA LLC Year Built: Accor:zmpliance rds maintained by the Town, the above noted dwelling, is with Town Code. Is not in compliance with Town Code. 7 77 The Legal Bedroom Count is- This information has been obtained from: Certificate of Occupancy: Other: ` I s The plans for the proposed addition are considered: Addition to existing house only Teardown and/or re -build allowed under Town Regulations Building Inspector Date 5. s^" ,\ jl � L T 0 1 A 1 _ A N -r T- µ.....5t ' v..,;- 2':AI�bN. .. :. 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N �xlsT ?, 305m: YA-w oAlc -8054- �t .Nbw$L W[ PALL, .. :. - _..__�.... - gxlfAf4W T22x DEGIDINL, )<IS71N4 P OOYL JOISY D 1 t N W.Zx1OC l4'O fi p 4.2 x 10 GONT. $M' - s I9 _Gnxly° F':frpOST• •--'•. 14cIDNA6p �°���(rz•3o1 INSut,. , }j 112'rMR)GYRBD-). •. - -2.2x¢ � `3 `•�� f ._ . E.X LS -T•. i .' u .b w / - - - i� Lpu11'DfzY pS� W `�017UM.N.UfJS"DA.M.P2.00FlN4- FSX151.GOFIG.}SfOI?B S I r fd`dhlT 1 /4 "40M „PAL'!,'I04 Y &f4 &AGE' ..- __ _. m - J( T _EXIST 5'auf.• (: _-- 2rAG+.tly "O,G,� .. 10" rOL.ID'. GONL 66r r 12 °�GDNG PIE(: i S II FDSN WALL. I I _ XISt STOFIE rl ; '2 x 4 P•.T. SILLS :BY.ISS..(OWC ,$6A4 -, �f.T,hoop�” A.ISEINF.LOI +L•SLAB% ifs I. ' e><ISf FIG• " {` frX-isf Footlw, :004 PO LY I 20 "X )all DeaO 5/l6ID { ! :.VAPOR :BAf.L'CBfl I S Lp . :6O1J6,_FTG. WL�L•t+�j 8A2•`• { 4 APAVLSL:FrLI {" LO.NT 60T ?0 M, A L� i 11 ii I V N 2,9 N of comer .It I'heraby certify to. - Janet' j6?runoll, • -chk.:* . Title - msvrance,POMPOY thai -'his riroppiRg !Vbosed on a field survey perfai'med oh' • thg, date indicated hereon, deeds an�lft'ir mdpsobtained from the County Clerk's ofrici.-I and Is correct and accurate to the best of mt, knowled & SUROCT to any easements, rights-of-ways, and /or I .9,;vements, that the utility companies may'have. SURZU to such facts disclosed by on accurote, L�P , -to-ddIe:-I1`t10 search. off'.17;UY shown hereon ore not- to be used- for . coq7struction purposes and /or fence installation. ass Q "Y "a -TAX MAP DATA:. Section: 62.10 Block.. I Lob. j5.35 J7 Deed Ubdr. .794, Page. 232 Deed.Libe• 1730, Pogo., 338 Deed Libor 1626 Page: 140 A. map entitled 'Mcawgna Lake Park Estate" 'filed in the.Patham County CleWs office on 29. December 1923 as map number 59C. Individual Lot Survap; of A and for. located in the rown o• f Puthom Volley OUjjA_'_ .PWhom e New -Xork tale:' rr 40. dote. 10 Ally. 2006 WrECEDE•. SURVEYNG. HOWARD W. WMPMP4 P9.M. 010 LICEIMSCO LAND SUMVEYON 62 Main Street Walden, N Y 12586 tel.: (845) 77B-.7643