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HomeMy WebLinkAbout2912DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.15 -1 -36 BOX 24 - 02912 Xcral r-16 , L ?r 02912 Xcral 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 IU 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 cc: BI (T) IA Stvwtii3d�Q4tigj 26.0' 24.0' ��p U 1 26.0' � 1 �p Yir�� 1 ' • 1 f I Q C�J 1 1 i �9 Fnd iood ' -Croro✓ d�iw/ro pries ��� WOW lecp oso � , � } I co ' 09� I �P e • ®` GP k � OQ ff \� kt if ,9 C 5ct ti o� I' 6dA -• \ i / /Pl/X'V �v C�3 vl� 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 col- - t.-.st ` i _ ro C7- �1r"Y7 t S cs GZ J 04-c n ALL V, lV[cAo or a c \'020 Q001 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 SMstz$ V 14.0° . 15.0 1 15. 4 D/R 6.0° 3,0 '0 °• kitchen 0 3.0 FB 4 ° 64 - _ - B/R LIVING a - - 1 26.0' BOOM 26. 0 ° SUNROOM • p 24.0° o 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 v 1 40,4'1914 �� �� � �ifiyy�.. r�2��� ✓ w%� �� C��d i-__ - -- " 11 �'1 U.' diiUEli ". .. 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- - o�l v JET ^"" `� i .. (/� ya��'vv -- o�l v A:lr- 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 01 C' C TF • 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