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631- 589 -8100
62.15 -1 -36
BOX 24
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02912
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02912
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Q N
ERUCE R. FOLEY, R.5
Acting Public He31th
DEPA4 l i`',_N T OF HEALTHH,
Divisizm 0 En:i-a-:-._n;al Health Services
Gene._ Roar, 6-C..:ei, Nev; York 10509
(91=) :70 -6130
R =SiD=N IAL 011,1'• -Y)
kql x m CIO,
It- `I�.��` ��� Y . • � / �i.V. \_ � W�_`"'_ CI,LiD i -T T� Y
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Description of Add itic- L S 10 Iq 0�
.:.:.5e of existing_ be -oc-.s _ ='o�.J; =d nu-ber of bedr �s S
iron: Cert ificale of CccuPan:cy or
Certification from E'..ldin:: InSJec o-
my a_di tion which is conS.teret a bE_. _': re-z-ArES forfnal approval Of planS
(Construction Permit) ^rep =.c b; a Pro-Essionlal Engineer or Registered Architect
n accordance with cJ^ I 1 CcJ I E S. ; iC; S G' this Putn?•1 County Sani teary Code.
I ease S'1Jtf1t �hlS iv. a -1: L - 10110e :4 „ t0 `:1111 =j I E
j �' CCUi+,`i1( h1,_TH 0.Pn?TM' Yi,
_ . i_fl. t(ie f ^llC�rJl l�` l'rfOi iia' iUnC =i,'_1!A RO. -0 B�EINS CR1, N 10509 '27G=v130 ?,li
1. Certified Check 10- $1CC -.00.
2. S:-:_tch of existing fioc- plan (alt iivina. area including basement, if any)
Non-professional dra-�,in; is ecceptabl=
3. Sketch of proposed 411aJ- plan. ' a �1
.Non professional drawing is accepta� "� /
4. Copy of survey sho- ing well and septic location, to the best of your
-knowledge. Include date of installation if knarm.
Include all wells and septic systems within 200 feet of property line. Any
questions please contact this office.
5. Copy of Certificate of Occupancy frc:- Torin or Certification from Building
Department of legal bedroom count of dwelling.
OFF ICE USE
Comments and /or conditions
.y1�j��.
J
s application
August 1995
July 1996 (Revised)
Stephen McEnery
82 Lakefront Road
Putnam Valley NY
Dear Mr. McEnery:
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
June' 0, 1998
10579
Re: Addition - McEnery, Lakefront Road
Increase in Number of Bedrooms
(T) Putnam Valley, TM# 62.15 -1 -3 6
BRUCE R. FOLEY
Pzeb�; Heath _ .... ^•7j:�
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 June
29, 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 one without prior approval by this
Department.
2. -- The area.:,f tha exisiing sewage disposal system, and -rts 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,
_ 4C 1
William Hedges
Sr. Public Health Sanitarian
WH :tn
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BRUCE R. FOLEY, P.$
Acting Public Health pirezt3;
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130 IC:4x 7
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Re:
Residence
Tax Map 64 �-15_ A3
Totivn
Gentlemen:
According to records maintained by the To`Nm, 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 Si tz sPc (I A__1 6 P
74t- C V
Building Inspe or
I
BRUCE. R. FOLEY - -
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
LORETTA MOLINARI R.N., M.S.N.
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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
October 15, 2002
media ampogna
53 Archer Road
Mahopac, New York 10541
Dear Mrs. Sampogna:
Re: Two (2) Bedroom Single Family Residence
82 Lake Front Road, (T) Putnam Valley
TM# 62.15 -1 -36
As we discussed, this Department will consider the above mentioned residence a pre - existing 2
bedroom single family residence.
This Department did approve an addition consisting of an laundry room/utility room in 1998. At
that time the residence was considered a one bedroom residence. The existing floor plan did
indicate that 2 small bedrooms were combined into one larger bedroom.
Based on this information, this Department has no objection to the Town of Putnam Valley
considering this structure to be a single family 2 bedroom residence.
Please bear in mind that any renovations or. additions to this structure will require approval by
both this Department and the Building Department of the Town of Putnam Valley.
Should you have any.questions, please contact me at 278 -6130, ext. 2168.
Sincerely, ..�..� •
William Hedges
Sr. Public Health Sanitarian
WH: cj
cc: Building Inspector, (T) Putnam Valley
Zoning Board of Appeals, (T) Putnam Valley
10/09/2002 11:52 FAX 18456286123
FAX
, L HE ES
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OCT -9 -2002 WED 11:52 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT nF P 1
:52 FAX 18456288123
FAX
DEPARTMENT OF HEALTH
Division of Rayironmead Heffft Se"kw
4 Germ Road
8MWSbM, New YO* 10509
Zd*.(914).278r6130 F=(914)279-7921-
June 30, 1999
Stephen MaEuexy
82 Lakefront Road
Putnam Valley NY 10579
Addition -; McEnexy, Lakefront Road
Increase in Number of Bedrooms
M Putnam Valley, TM# 62.15 -1 -36
Dear W McEtieT.
Q 002
MM
Public Health Director
I bave received and rmiewed the plans for the proposed addition to the above mentioned residence.
The proposal for the adMon has been approved as per plans bearing the latest revision date of June
29, 1998 and this Department's approval stamp.
Based: on the information submitted, the above mentioned addition is approved wa the following
conditions:
1. The total number of bedrooms must ri main at one without prior approval by this
Department
..2. The area of the odaing sc-waige- c4pab-&'- iyaaiL4 and - its dkpansion area, mug be
3, All ph=bmg factures must be updated with water saving devices, Le, new tow
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 Pubmm Valley.
If you have any questions, please contact: me at your convenience.
Very truly yours,
. .... .. ... ...... . ................ .................
William Hedges
Sr. Public Hiealth- Saukarian,
WH-ta
cc-- B1 (T)
0
OCT-9-2002 WED 11:52 TEL:845-278-7921 NAME:PUTNRM COUNTY DEPARTMFNT nr P 7
to /us/2002 �11�.52 FA% 18456286125 FAX 16003
ZN
BRUCE R. FOLEY, p c
Acting Public lieatth' oire�ca
DEPARTMENT OF HEALTH
Divisioh Of Environmental Health Services
4 Geneva Road, Brewster, New - York _ 10509.
(914) 278 -6-UO' F4X k
Putnam County Dept of Health
4 Geneva Road ]�r�io�'� •/�"�7r'r. j`i
Brewsler, NY 10509
Re:
Residence
Tax Map 15 f cj�o
Gentlemen:
According to records maintained by the ToNNn, the above rioted d-welling
IS
V-5 NOT
in compliance Nr1th Tone code and the total number of bedrooms on record
This information has been obtained from:
CERTIFICATE Of OCCUPANCY:
ASSESSORS RECORD:
OTHER I`�.s 6
Building Ins r
P
^nr,T -9 -2002 WED 11:52 TEL:845- 278-7921 NAME_PUTNAM COUNTY DEPARTMENT nF
luivaiZUU2 11:52 FAX 18456286123
FAX Q004
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OCT -9 -2002 WED 11:53 TEL:845 -278 -7921
NAME:PUTNAM COUNTY DEPARTMENT OF P_ 4
I�'D
_ _.. t3RUCE':k "" FOLEY' ... _ _ _ ...._- ._....
Public Health Director
w LORETTA MOLINARI R.N., M.S.N.
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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
October 15, 2002
Karin Sampogna
53 Archer Road
Mahopac, New York 10541
Re: Two (2) Bedroom Single Family Residence
82 Lake Front Road, (T) Putnam Valley.
TM# 62.15 -1 -36
Dear Mrs. Sampogna:
As we discussed, this Department will consider the above mentioned residence a pre - existing 2
bedroom single family residence.
This Department did approve an addition consisting of an laundry room/utility room in 1998. At
that time the residence was considered a one bedroom residence. The existing floor plan did
indicate that 2 small bedrooms were combined, into one larger bedroom.
Based on this information, this Department has no objection to the Town of Putnam Valley
considering this structure to be a single family 2 bedroom residence.
Please bear in mind that any renovations or additions to this structure will require approval by
both this Department and the Building Department of the Town of Putnam Valley.
Should you have any questions, please contact me at 278 -6130, ext. 2168.
Sincerely,
William Hedges
Sr. Public Health Sanitarian
WH: cj
cc: Building Inspector, (T) Putnam Valley
Zoning Board of Appeals, (T) Putnam Valley
Public Health Director .
D. 4
.. "LORI; fT'A PMO'LINARI� R.N., M.S N.
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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
October 15, 2002
Karen Sampogna
53 Archer Road
Mahopac, New York 10541
Re: Two (2) Bedroom Single Family Residence
82 Lake Front Road, (T) Putnam Valley
TM# 62.15 -1 -36
Dear Mrs. Sampogna:
As we discussed, this Department will consider the above mentioned residence a pre - existing 2
bedroom single family residence.
This Department did approve an addition consisting of an laundry room/utility room in 1998. At
that time the residence was considered a one bedroom residence. The existing floor plan did
indicate that 2 small bedrooms were combined into one larger bedroom.
Based on this information this Department has no objection to the Town of Putnam Valley
considering this structure to be a single family 2 bedroom residence.
Please bear in mind that any renovations or additions to this structure will require approval by
both this Department and the Building Department of the Town of Putnam Valley.
Should you have any questions, please contact me at 278 -6130, ext. 2168.
Sincerely,
William Hedges
Sr. Public Health Sanitarian
WH: cj .
cc: Building Inspector, (T) Putnam Valley
Zoning Board of Appeals, (T) Putnam Valley
9' ' 2.%
Public Health Director
9 x
C
+s. LORETTA rMOLINARI R.N., M.S.N.
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/Preschool (845) 278 - 6014 Fax (845) 278 - 6648
October 15, 2002
&,V)
-L
a - SU�
ampogna
53 Archer Road
Mahopac, New York 10541
143
Dear Mrs. Sampogna:
Re: Two (2) Bedroom Single Family Residence
82 Lake Front Road, (T) Putnam Valley
TM# 62.15 -1 -36
As we discussed, this Department will consider the above mentioned residence a pre - existing 2
bedroom single family residence.
This Department did approve an addition consisting of an laundry room/utdity room in 1998. At
that time the residence was considered a one bedroom residence. The existing floor plan did
indicate that 2 small bedrooms were combined into one larger bedroom.
Based on this information, this Department has no objection to the Town of Putnam Valley
considering this structure to be a single family 2 bedroom residence.
Please bear in mind that any renovations or additions to this structure will require approval by
both this Department and the Building Department of the Town of Putnam Valley.
Should you have any questions, please contact me at 278 -6130, ext. 2168.
Sincerely, -
William Hedges
Sr. Public Health Sanitarian
WH: cj
cc: Building Inspector, (T) Putnam Valley
Zoning Board of Appeals, (T) Putnam Valley
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
October 20, 1987
Mr. Jack Gutcheon
82 Lakefront Road
Putnam Valley, New York 10579
Dear Mr. Gutcheon:
JOHN SIMMONS, M.D.
Deputy Commissioner
JOHN KARELL, Jr., P.E.
Director
RE: Proposed Well Construction
Gutgheon- Lakefront Road
(T) Putnam Valley - 5 -2
You are hereby advised that your request for a variance from
provision of the required 100 foot separation distance.between
your proposed well and the proposed sewage disposal system on
your property has been considered by the Bbard of Health on
October 19, 1987 and denied.
- :., ":_ ..� .. ! __...:.... _ _.._ry .....: ..
rBIYasrd y truly y rs ,
and Jones
ident of Health
RJ:pt
cc:Building Inspector
JK
File
RJ
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
Jack Gutgheon
82 Lakefront Road
Putnam Valley, New York 10579
Dear Mr. Gutgheon:
September 16, 1987
JOHN SIMMONS. M.D.
Deputy Commissioner
JOHN KARELL, Jr., P.E.
Director
RE: Proposed Well Construction
Gutgheon Lakefront Road
(T) Putnam Valley -5 -2
Review of an application to construct a well for potable water supply purposes
to serve the above- captioned property has been completed.
Such review indicates as follows:
1. The lot is presently served summer water by the Wildwood Knolls Water
District. The proposed well on your lot is located 60 feet from the
existing sewage disposal system located on this lot. A one hundred
foot separation distance is required.
2. The proposed well on your lot is located 80 feet from the existing
sewage disposal systems located o.i two adjacent- lots.
Recognizing the above, your application for a permit to construct a well on this
property is hereby denied.
Reference is made to your letter dated August 8, 1987, received in this office
on September 14, 1987, which letter contains a variance request.
Please be advised that your request for a variance from the minimum well to
sewage system separation distance will be considered at the meeting of the Board
of Health scheduled for October 19, 1987 at 7:30 P.M,, in the Conference Rocco of
our offices at BOCES, Building #3, Old Route 6, Carmel, New York.
You or your representative should be present to discuss your reasons and
justification for the variance.
If you have any questions, feel free to contact me at ext. 304.
JK:mk
cc: R. Jones, Pres, BOH
JK
File
Ve y yours,
i
ohn Kar
Director
Environmental Health Services
a-
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
Jack Gutgheon
82 Lakefront Road
Putnam Valley, New York 10579
Dear Mr. Gutgheon:
September 16, 1987
JOHN SIMMONS. M.D.
Deputy Commissioner
JOHN KARELL, Jr., P.E.
Director
RE: Proposed Well Construction
Gutgheon - Iakefront Road
(T) Putnam Valley -5 -2
Review of an application to construct a well for potable water supply purposes
to serve the above- captioned property has been c mpleted.
Such review indicates as follows:
1. The lot is presently served summer water by the Wildwood Knolls Water
District. The proposed well on your lot is located 60 feet from the
existing sewage disposal system located on this lot., A one hundred
foot separation distance is required.
2. The proposed well on your lot is. located 80 feet from the existing
savage disposal systems located. on two .adjacent bats.
Recognizing the above, your application for a permit to construct a well on this
property is hereby denied.
Reference is made to your letter dated August 8, 1987, received in this office
on September 14, 1987, which letter contains a variance request.
Please be advised that your request for a variance from the minimum well to
sewage system separation distance will be considered at the meeting of the Board
of Health scheduled for October 19, 1987 at 7:30 P.M., in the Conference Roan of
our offices at BOLES, Building #3, Old Route 6, Carmel, New York.
You or your representative should be present to discuss your reasons and
justification for the variance.
If you have any questions, feel free to contact me at ext. 304.
JK:mk
cc: R. Jones, Pres, BOH
JK
File
Ve trtiy yours,
I
ohn Kar , o P. .
Director
Environmental Health Services
b
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ui1 -
y County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
September 3, 1987
Jack Gutgheon
82 Lakefront Road
Putnam Valley, NY 10579
Dear Sir:
RE: Proposed Well Construction
Application # M
82 Lakefront Road
(T) Putnam Valley
JOHN SIMMONS. M.D.
Deputy Commissioner
Review of the above captioned application has been completed..
Additional information or clarification is required as checked below:
✓ 1. A detailed reason for drilling the well is required. A short narrative is
required. For what purpose will the well be used, .i..e., drinking, lawn
watering, etc.
✓2. Is the site presently served by a well? Explain.
Is the site .presently served by a sewage disposal system? Explain.
-4, Is the present structure to-be reconstructed? Expanded? How?
5. A sketch showing the location of:
v K. - the proposed well
_.;. -� .- rna ex,sLng•s� age s�st�z cri .uiis parcel '
oF.- - the existing house on this parcel
- existing sewage systems and wells on adjacent parcels within 200 feet of
the proposed well.
all of the above is not provided.
The .sketch provided is not sufficiently detailed. See #5 above.
Upon receipt of the above information this application will be considered
further.
Vety truly y urs,
'John Karel, Jr., P.E.
'Director Environmental Health Services
jk -3
TWO ..000NTY CENTER.- CARMEL, N.Y. 10512 (914) 225 -3641
DEPARTMENT OF HEALTH ,q{ r .
Division Of Environmental H%a Services V
TWO COUNTY CENTER — CARMEL, N.Y. 10512 (914) 225 -3647 J. _
. t ,
APPLICATION TO CONSTRUCT A WATER WELL
WELL LOCATION
c A S
IUWNIYILLAG 11.1 Y IAX Vio NUM8EA. r3
- �� �L ��'
'
c�� E
i�DN t' o !7vT /1 V/!l
�/ ►os� rt i�t ! A
WELL OWNER
NAME. • ADDRESS:
C 0 �� ��ze Av -r TNA
R'OSIVATE
❑ .EUSLIC
USE OF WELL
&�RESIDENTIAL
O PUBLIC SUPPLY -❑ AIR /COND.'/HEAT PUMP
❑ ABANDONED
1 - primary
O BUSINESS
O FARM O TEST /OBSERVATION
❑ OTHER (specify)
2 -. secondary
❑ INDUSTRIAL
O INSTITUTIONAL O STAND -BY
Cl
MOUNT OF USE
YIELD SOUGHT
gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE oat.
REASON FOR
0'/NEW SUPPLY
O PROVIDE ADDITIONAL SUPPLY
O TEST /OBSERVATION
DRILLING
C1 gEPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL
WELL TYPE Q� DRILLED F__j DRIVEN Ej DUG E] GRAVEL F_� OTHER
IS WELL SITE SUBJECT TO FLOODING? YES V NO
IF VIFLL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
LOT NO.:
WATER WELL CONTRACTOR: Name 41VOe-R50W Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO ON
NAME OF PUBLIC WATER SUPPLY- ro"C> 00 rYve 115- T0W-N V/C � � i /:
fgp�huuw &ky G�-+°►!Z ! 6 %!2 t �i v�i(%lQf1(. 6' /�' /Jt= y
DISTANCE TO PROPERTY FROM N•EAPFST WATER.- -MATH
LOCATION SKETCH & SOURCES OF CONTAMINATION.
(date) f (sign ture) _ --
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.
Date of Issue: 19
Permit Issuing Official
Permit-is-Non-Transferrable-
-
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HE ........ .
WW-Y NLTH.-DEPARTWW----
DIVISION OVENVIRONMUAL HEALTH SERVICES
John M. Simmons, M.D.
Deputy Commissioner of Health FIELD ACTIVITY REPORT -
1AME
ADDRESS Ly 2- �A'
Street Town TH No.
MAILING ADDRESS &,;20 i� ICI" /-
P.O. Bmc Post Office*
TELEPHONE
PERSON IN CHARGE
OR INTERVIEWED
Name and Title
DATE TYPE FACILITY
TIME ARRIVED
TIME LEFT
FINDINGS:
Sheet of 1.
11tl�rSA:11V V'
Orig. Routine
Orig. Complain
Orig. Request
Compliance
Ccaplaint Ccmp
Final
e -o b4 -D- Group Illness
construction.
Reinspection
Field, Sampling Only
Field Conference
Other
Explain
124SPBMR:
PERSON IN CHARGE OR INTERVIEWED:
Tacknowledge this Field.Activity Report. SIGN&TURE:
(1/86 TITLE:
TELEPHONE-.
DAVID D. BRUEN M v
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
September 3, 1987
Jack Gutgheon
82 Lakefront Road
Putnam Valley, NY 10579
Dear Sir:
RE: Proposed Well Construction
Application # 0
82 Lakefront Road
(T) Putnam Valley
JOHN SIMMONS. M.D.
Deputy Commissioner
Review of the above captioned application has been completed.
Additional information or clarification is required as checked below:
A. A detailed reason for drilling the well is required. A short narrative is
required. For what purpose will the well be used, i.e., drinking, lawn
watering, etc.
✓ 1. Is the site presently served by a well? Explain.
�/3. Is the site presently served by a sewage disposal system? Explain.
�4. Is the present structure to be reconstructed? Expanded? How?
5. A sketch showing the location of: ..: =-
OK- the proposed well
- =- = 'che existinng sewage system on this parcel
G K -- the existing house on this parcel
- existing sewage systems and wells on adjacent parcels within 200 feet of
the proposed well.
- all of the above is not provided.
V/6. The sketch provided is not sufficiently detailed. See #5 above.
Upon receipt of the above information this application will be considered
further.
Vety truly y urs,
John Karen, Jr., P.E.
JK:mk Director Environmental Health Services
cc: Bldg. Insp. .
F /L /jk -3
TWO. COUNTY CENTER.- CARMEL, N.Y. 10512 (914) 225 -3641
bAVID D. BRUEN
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
September 3, 1987
Jack Gutgheon
82 Lakefront Road
Putnam Valley, NY 10.579
RE: Proposed Well Construction
Application # 0
82 Lakefront Road
(T) Putnam Valley
Dear Sir:
F
JOHN SIMMONS. M.D.
Deputy Commissioner
Review of the above captioned application has been canpleted.
Additional information or clarification is required as checked below:
1. A detailed reason for drilling the well is required. A short narrative is
required. For what purpose will the well be used, i.e., drinking, lawn
watering, etc.
2. Is the site presently served by a well? Explain.
t/3. Is the site presently served by a sewage disposal system? Explain.
t/4. Is the present structure to be reconstructed? Expanded? How?
5. A.sketch showing the location of:
�t< -- the. proposed well -
ti`ie existing sewage system on this parcel
c- K -- the existing house on this parcel
f - existing sewage systems and wells on adjacent parcels within 200 feet of
the proposed well.
- all of the above is not provided.
V6. The sketch provided is not sufficiently detailed. See #5 above.
Upon receipt of the above information this application will be considered
further.
Vely truly y urs,
John Karen, Jr., P.E.
JK:mk Director Environmental Health Services
cc: Bldg. Insp.
F/L /jk -3
TWO. COUNTY CENTER.- CARMEL, N.Y. 10512 (914) 225 -3641
DEPARTMENT OF HEALTH
Division of Environmental Health Services
110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310
_ .. :p:Ppr.iC.'Ar jC'j: i:r...""" c"�RUC.T A WA-TER. ELL'
PCHD PERMIT # W <5Q I 41
WELL LOCATION
St et Address p
'r /C bJ
To Village ��Ctf
(JI �/✓ � L `=
Tax Grid Number
WELL OWNER
��ss Name Ma * 1 '
C3 "o FE 6$ IV IJAD
Address `
Al 1,011AV;C J % Y
rivate
kd' ,O O Public
USE OF WELL
primary
,2 - secondary
RESIDENTIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O ABANDONED
® BUSINESS 0 FARM O TEST /OBSERVATION p OTHER (specify
® INDUSTRIAL C31NSTITUTIONAL 0 STAND -BY O
AMOUNT OF USE
YIELD SOUGHT _gpm /#
.REPLACE EXISTING SUPPLY
�❑ NEW SUPPLY NEW DWELLING
PEOPLE SERVED d 'f' /EST.
O TEST /OBSERVATION
D DEEPEN EXISTING WELL
OF DAILY USAGE_ Z�gal
LZ ADDITIONAL SUPPLY
REASON FOR
DRILLING
DETAILED
REASON FOR
DRILLING
WELL. TYPE
RILLED ®DRIVEN
®DUG
GRAVEL
0 OTHER
IS WELL SITE SUBJECT TO FLOODING? YES & NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: "o
Lot No.
WATER WELL CONTRACTOR: Name &d 97 Q56 Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: RYES NO St'�4 S0&fQ'6
NAME OF PUBLIC WATER SUPPLY:
TOWN
DISTANCE TO .PR7PFRTY. FROM NEA.REST -[lA_..R MAIN • /,k/
LOCATION SKETCVON SOURCES OF CONTAMINATION PROVIDED
7/r3 / SEPARATE SHEET
Wel�da e)) (signature)
to be staked by licensed surveyor and location to be confirmed by a representative of
disinfection system to be installed.
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 driAing operations be contained on this
property and in such a manner as not tto� degrade or otlAelokse contaminate surface or groundwater.
Date of Issue: Z 19
Date of Expiration 19 ermit Is ing Official
Permit is Non - Transferrable yWhh��i�te copy: HD File sspp Pink copy: Owner
3/89 APPROVED BY SPECIFIC WAIVER REFER TO WAIVES f$RyRESTR�CTI0N5� Orange copy: Well Driller
NEW YORK STATE DEPARTMENT OF HEALTH Specific Waiver
Bureau of Community Sanitation and Food Protection from Requirements of Part 75 and Appendix 75- A,10NYCRR
a for !ndlv!dual Househc!d awaga TrPi+ ry. ":?"ie S terns
- - -- - SW -9 -97
Name of Applicant Gutcheon
No. Street City/Town State Zip
Address 82 Lake Front Road PUtnam Vallev. NY 10579
Site Location 82 Lake Front Road
Putnam Valle
1. Reason why site does not meet 10NYCRR Appendix 75 -A (check appropriate box(es)):
;A1 Separation distance cannot be achieved.
Excessive slope.
High groundwater.
Inadequate depth to bedrock or impermeable layer.
J Soil unsuitable.
Other(explain) ............................................................................................................ ...............................
................................................................................................................................................................................................................. ...............................
.......................................................................................... ...............................
2. Proposed design or conditions of waiver: i
..8.0. ... and .... 8. 7.. ... fe. e. t .... to ... an ... SSD. S ,--- double .... cased .... well., .... ultra ... viole -t.... sinfe-etion s.ystem
Well location to be staked by a licensed surveyor and location is to be
corif'ifined" i yy...d repfesentafive....0ff ffs bepartment prior to the construction of
.the ... we ll.. ....................................................................... ............................... _.......................................................................... ...............................
........................................................................................................................................................................................................................................................... ...............................
3. The proposed design may have the following limitations (check appropriate box(es)):
J Increased risk of well or spring contamination.
Increased risk of surface water contamination.
Expected design life of the system will be diminished.
. � Operation of sewage system is subject to mechanical problems.
Other(explain) ............................................................................. ............................... '•
........................................... ...............................
Additional information attached
Construction pursuant to this waiver request should not pose any foreseeable health or environmental problems. in accordance with
New York State Department of Health Administrative Rules and Regulations, Part 75.6 (b), a waiver is hereby granted. This waiver
may be revoked by to-iiiluing official for a change in conditions for which this waiver was granted.
.......... ................................. ...............................
TIVE OF MMIS §TONER OF HEALTH
ORIGINAL -Local Health Agency
2 .' COPY - Applicant /Design Professional
OOH -1326 (7/92) (GEN -152)
March 10, 1997
,-GUTCH.EOM:'
PATCHWORKS, I .
Manufacturers of The American Classic Line''M
cotton prints and plain colors
Putnam County Dept. of Health
Mr. Robert Morris
4 Geneva Rd. Rt. 312
Brewster NY 10509
Re: the parcel at:
82 Lakefront Rd.
Putnam Valley NY 10579
Dear Sir:
This letter is to advise you that title to the abovementioned
property was transferred to myself and my sister, Peppi Gutcheon Graves,
on May 23, 1993 as noted on the survey map as "Putnam County Clerk's
Lib.er 1204 - 342(3)."
As the original request for a variance was made by my father and. -_-
-- - -- fcrmer owner Jack- Gu'uch% -_0n, live- ask that ynu continue this wa Ver re- +
quest in the names of the current owners:
Jeffrey Gutcheon
Peppi Gutcheon Graves
Thank you for your consideration.
Sinc rely,
Jeffrey Gutche
cc: Peppi Gutcheon Graves
Jack Gutcheon
917 Pacific Avenue, Suite 305 Tacoma, WA 98402 206 - 383 -3047 FAX 206 - 627 -1399
Applicant: Jeffrey D. /Peppi Gutcheon (Graves)
82 Lakefront Road
Putnam Valley., N.Y. 10579
Notification Letters Sent To:
David Weiner /Geraldine Sarnataro
Apt. 7G 25 E. 86th Street
New York, New York 10028
Dr. Marvin Freid
84 Mill Road
Putnam Valley, N.Y. 10579
Lawrence/ Susan Schulman
1 Adrian Circle
Scarsdale, N.Y. 10583
Ginger /Glenn Lefurgy
70 Mill Road
Putnam Valley, N.Y. 10579
March 3, 1997
Putnam County Department of Health
Mr. Robert Morris
4 Geneva Road, Route 312
Brewster, New York 10509
Re: Waiver Request
Owner's Name: Mr. Jeff Gutcheon
82 Lakefront Road
Putnam Valley, N.Y. 10579
This letter is to request a waiver be granted in the matter of the above
referenced property for the purpose of drilling a well on private
property.
The application which was submitted to the Department of Health was
denied for the following reasons:
The separation distance between the proposed well location and the
existing
septic systems is approximately 90 feet to the trench; 80 feet to leach
A reduction in the required 100 foot separation distance is requested in
addition to a reduction in SSDS expansion area.
Please take into consideration that this variance recgst is being
submitted along with several others in the Wildwood Knolls'
Improvement District. This District is attempting to discontinue it's
seasonal water system which has become antiquated and a financial
burden to the entire district.
Town of Putnam :.
February,26, 1997 ,
i
Ginger /Glenn Lefurgy
70 Mill Road
Putnam Valley, NY 10579
Dear Ginger /Glenn:
Re: Review by the Putnam County Department of Health of
proposed well for the following property:
Name of Owners: Jeffrey D. Gutcheon/
Peppi Gutcheon Graves
Street Address: 82 Lakefront Road, Wildwood Knolls
Tax Map Number: 62.15 -1 -36 (Town of Putnam Valley)
Please be advised that the owners of the above property have
applied to the Putnam County Department of Health for a permit to
construct a well at the location shown on the attached site plan.
If, as neighboring property owners, you have any questions,
concerns or information which may influence.the Department's
review of this application, you may call Mr. Robert Morris of the
._ Department at _.9.14 -2.78-r? 130., _Extension .166..
To let us document for the Department that you have received this
notification, please complete the acknowledgement below on one
copy of this letter, and return that copy to me right away, using
the enclosed stamped envelope.
In duplicate
Received by;
Printed Nam(
Sincerely,
Lenore A. Herbert
District Administrator
914 - 526 -3293
Property Tax Map No. 62.15 -1 -40
(Signature)
i
Date : - e _ / "7
A
265 ®scawana Lake Road ® Putnam Valley, New York 1057.9 11 (914) 526.3280,,„ ;,�,,
\li
Town of Putnam Valley
February 26, 1997
Lawrence /Susan Schulman
1 Adrian Circle
Scarsdale, NY 10583
Dear Mr. and Mrs. Shulman:
Re: Review by the Putnam County Department of Health of
proposed well for the following property:
Name'of Owners: Jeffrey D. Gutcheon/
Peppi Gutcheon Graves
Street Address: 82 Lakefront Road, Wildwood Knolls
Tax Map Num er: 2.15 -1 -36 (Town of Putnam Valley)
Please be advised- ,that.the owners of the above property have
applied to the 'Putnam.County Department of Health for a permit to
construct a well..at.the location- shown- on- .the.attached site plan.
If,'as neighboring property owners, you have any questions,
concerns or information which may influence the Departments
review of this application, you may call Mr. Robert Morris of the
Department at 914 - 278 -6130, Extension 166.
To. let. "'s dc;;umant fir tiie Department "that you have received this
notification, please complete the acknowledgement.below on one
copy of this letter, and return that copy to me right away, using
the enclosed stamped envelope.
Sincerely,
Lenore A. Herbert
District Administrator
914 - 526 -3293
In duplicate
Al-'
265 Oscawana Lake Road • Putnam Valley, New York 10579..0.. (914) .526- 3280,,y ,;.� ..,.. ;.
Town of Putnam Valley
February 26, 1997
Dr. Marvin Freid
84 Mill Road
Putnam Valley:, NY 10579
Dear Dr. Fried:
Re: Review by the Putnam County Department of Health of
proposed well for the following property:
Name of Owners: Jeffrey D. Gutcheon/
Peppi Gutcheon Graves
Street Address: 82 Lakefront Road, Wildwood Knolls
Tax Map Number: 62.15 -1 -36 (Town of Putnam Valley)
Please be advised that the owners of the above property have
applied to the Putnam County Department of Health for a permit to
construct a well at the location shown on the attached site plan.
If, as a neighboring property owner, you have any questions,
concerns or information which may influence the Department's
review of this application, you may call Mr. Robert Morris of the
Department at 914- 278 -6130, Extension 166. -.-
-- --= o--let us document for the Department that you have received this
notification, please complete the acknowledgement below on one
copy of this letter, and return that copy to me right away, using
the enclosed stamped envelope.
In duplicate
Received by:
Printed Name:
Sincerely,
Lenore A. Herbert
District Administrator
914 - 526 -3293
Property Tax Map No. 62.11 -1 -15
ignature
te:
265 Oscawana Lake Road ® Putnam Valley, New 'York 10579 @ (914) ,526- 32801,,,s�i ,' ". �
Town of Putnam Valley
February,26, 1997
David Weiner /Geraldine Sarnataro
Apt 7G, 25 E 86th St
New York, New York 1000
Dear Mr. Weiner /Ms. Sarnataro:
Re: Review by the Putnam County Department of Health of
proposed well for the following property:
Name of Owners: Jeffrey D. Gutcheon/
Peppi Gutcheon Graves
Street Address: 82 Lakefront Road, Wildwood Knolls
Tax Map Number: 62.15 -1 -36 (Town of Putnam Valley)
Please be advised that the owners of the above property have
applied to the Putnam County Department of Health for a permit to
construct a well at the location shown on the attached site plan.
If, as neighboring property owners, you have any questions,
concerns or information which may influence the Department's
review of this application, you may call Mr. Robert Morris of the
Department at 914 - 278 -6130, Extension 166.
To let us document for the Department that you have received this
notification, please complete the acknowledgement below on one
copy of this letter, and return that copy to me right away, using
the enclosed stamped envelope.
In duplicate
Received by:
Printed Name:
Sincerely,
Lenore A. Herbert
^4 -4-:-` "dministrator
93
Property Tax Map No. 62.15 -1 -37 & 38
(Signature'
Date:
i
265 Oscawana Lake Road • Putnam Valley, New York 10579~;,!,; ,.0 914) 52673280,,,,;;�,,,;,,�
HMON
TA 1L Cie N
cu _LL
TO
O_
lov'
19�
15
f o {
1� 0 b�
D
�Q X38
V w� 37
;no
' � � - �.�• 1. ��.. r• .a` �` .J`_''r.'.v. �. � •a1..t •.t'�„
P,PVCE R. FOLEY. R.S. -
Xc-wn Putfic. Health oareC-cr
UZ,
In Ught of the foregoing,, your application -i is hereby ijenied
Wi h al -1
-ons -Wit.1 h en denied, And as' yo
-For. t h 6 -reac ...-d above your app!,jration-has P
I ii-al's-it-'is-wi thin- your-- rights to-- request-a- variance- from- the.- Putnam -County-- -
Bo . aM of Health. Guidelines for the variance procedure have been enclosed'.
Tt.is'Department has been in correspondence with Ms. Marianne D.iSantis; Pis rict
�
Administrator, Town of Putnam Valley. It has been the Putnc -,�n County Hea t h
Department's position that all thirteen homes reported as currently being.
supplied by the Wildwood Knolls for variances he
same time. - -Tf�e �WAter service be considered. o ances a
in en ion- b-einj,,,`VMt=, i .--permittabl-e-;-a: ---tfff
fe—eh h6ffies- wo.u-
removed from the water service. "" At this time it appears com plete Applicatlons
.
have been submitted for 10 of the 13 homes on the water system. At the request
of Jim Gordon, Putnam County Legislator, determinations (denials or approvals)
are being considered for all completed applications.
Please be advised that the Board of Health may require that all thirteen
proposals be considered at one time.
RM/ P
very truly yours,
Robert Morris, P. E.
Public Health Engineer
0 o
(0 99.0'
Al 16 Pro �er
� ;O S�(fi L �'�►<
135.78 ® �� ►� ��r
X13.73 ZZ
Vto
00 o� 15
\
14,v
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• c
14 -16.4 (087)- -Tent 12 /�
PROJECT I.D. NUMBER 617.21 SEOR
Appendix C
State - Environmental Quality Review
_, _ _ .... _. _ - - • SA RTINMONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART 1— PROJECT INFORMATION (To be completed by Applicant or Project sponsor)
1. APPLICANT /SPONSOR
2. PROJECT NAME
Gutcheon
Wildwood Knolls
3. PROJECT LOCATION:
Municipality Putnam Valley County Putnam
4. PRECISE LOCATION (Street address and road Intersections, prominent landmarks, etc., or provide map)
82 Lake Front Road,. Putnam Valley
TM 462.15 -1 -36
5. IS PROPOSED ACTION:
❑ New ❑ Expansion ❑ Modificationlalteratlon
6. DESCRIBE PROJECT BRIEFLY:
Construction of water well
7. AMOUNT OF LAND AFFECTED:
Initially 1/4 acres Ultimately 1/4 acres
.8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
❑ Yes ❑ No If No, describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
® Residential ❑ Industrial ❑ Commercial ❑ Agriculture ❑ Park/ForestlOpen space ❑ Other
Describe: 1
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL,
STATE OR LOCAL) ??
❑ Yes u No If yes, list agency(s) and parmlUapprovals
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
❑ Yes 10 No If yes, list agency name and permit /approval
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT /APPROVAL REQUIRE MODIFICATION?
❑ Yes ®No
I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE
Applicant /sponsor name: Date:
Signature:
If the action is in the Coastal Area, and you are a state agency, complete' the
Coastal Assessment Form before proceeding with this assessment
OVER
1
PART 11— ENVIRONMENTAL ASSESSMENT (ro :be completed by agency)
A. 130ES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR, PART 617.12? If yes, coordinate the review process and use the FULL EAF.
❑ Yes t J No
B. WILL ACTION RECEIVE COORDINATED AS PROVIUEn FOR UNLISTED ACTIONS IN 6 NYCRR. PART 617.6? if No, a negative declaration
r Is:•e %srd =^ by anot�a. lr,voaaa4gbnc ., a _ _ _. .
❑ Yes No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, If legible)
C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic patterns, solid waste production or disposal,
potential for erosion, drainage or flooding problems? Explain briefly:
C2. Aesthetic, agricultural, archaeological, historic, or other natural. or cultural resources; or community or neighborhood character? Explain briefly:
V CAI- '�ZUM O U`S
C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly:
O
C4. A community's existing plans or goals as officially adopted, or a change In use or Intensity of use of land or other natural resources? Explain briefly.
C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly.
KID
C6. Long term, short term, cumulative, or other effects not identified In C1-05? Explain briefly.
�0
C7. Other Impacts (including changes In use of either quantity or type of energy)? Explain briefly.
�V
{
0 IS THE E, OR IS THERE LiKELYjO BE. CONTRr1VFRSv RE! -ATED To PONENI T !ps':�%bl"E'ME-E'1. "R,ONKICUTAL iMPACT3i
❑ Yes No If Yes, explain briefly
PART III — DETERMINATION OF SIGNIFICANCE (ro be completed by Agency)
INSTRUCTIONS: For each adverse effect Identified above, determine whether It Is substantial, large, Important or otherwise significant.
Each effect should be assessed In connection with Its (a) setting (I.e. ,urban or rural); (b) probability of occurring; (c) duration; (d)
Irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that
explanations contain sufficient detail to show that all relevant adverse Impacts have been Identified and adequately addressed.
❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY
occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration.
�Q Check this box if you have determined, based on the Information and analysis above and any supporting
documentation, that the proposed action WILL NOT result In any significant adverse environmental Impacts
AND provide on attachments as necessary, the reasons supporting this determinaflon:
A G u YJ 7.4 W- PA e F M EP r of f T-E-A�-r-P
Name of Lead Agency
e o Resonsi p e Officer in Lea Agency it le qk Responsible 0 ficer
re oVesponsible Officer in Lead Agency Signature of Preparer (if differ-e-n-t-fr-omtesponsible officer)
I
9