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Home My WebLink About3035DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.18 -1 -55 BOX 25 ' _ 1 % 1 , i1 4 0 ri 03035 11RUCE. ;R. FOLEY, AS— - . . Acting Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 October 16, 1996 Jenny Lax 2317 1,� Hollyridge Drive Los Angeles, CA 90068 Re: Addition - No increase in number of bedrooms 12 Azalea Drive (T) Putnam Valley Dear Ms. Lax: 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 September 6, 1996 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 two without prior approv aT- by tment : _ _.... _.._ _ ....__.... _ . -. • __ ._ .... _..___ . __ -... 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e.,new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Ver truly yours, Robert Morris, P. E. Public Health Engineer RM /jp DEPARTMENT OF, HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 a Q} ('914) 278 -6130 D Re: Addition _ d ®40 Dear KI I have received and reviewed the plans to the above mentioned residence. - BqUU -R: FOLEY; -- R.S. Acting Public Health Director No increase in number of bedrooms fP w uv for the proposed additions The proposal for the addition has been approved as per plans bearina the latest revision date of 546 land 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 at2,-without prior approval by this Department. 2. The area of the.existing sewage disposal system, and its expansion area, must be maintained. :....._� .__.... _. -:_._ ?..a. .�11 -1 p mb ng .fixt:ii_rb must be- .�ipd ted -with T devices, i.e.,new low flush toilets, restrictors for shower heads and faucets, etc. Any other permits or variances required are the res onsibili6�c- If the applicant and the jurisdiction of the Town of you have any questions, please contact me at your convenience. Very truly yours, Robert Morris, P. E. Public Health Enaineer RM/jp O n I LAKE- FLD9vfLh4 6F Mpog LIVIAG Gfhc[ (Ap mcwfm CR VeEOED W IN SC LE 0, c% lilt) A 104,/-- 31 3, 44 CLOSET of -LIVIW 906M- T71 4 CLOSET ch klnHEtJ-: CII' 6" x 3111 LAKE l� i FrOJE U/COWCAM 14 LEDGE I9'4'' -3 ►. P&E LAKE 47.5TMf 11T, c "N 19'h" coeFeTE lak LL LEDGE 81 At iK �;uang rlG y FVOflPLF(N o Al" Z3FAMS+TAussf$ 0"e tRrA OF BASEM6N T - AffROX• 5�o►�E i�=1 W/rIL s�Enff� 1 vTAAryook i4 NOTED �t tEiuAG WITH l A o 6ajtt� l DOES. 6, I �^ to ;nbrlockd ' lOu IODUl :. DOORS 1 1 T4 ROCK b Cogtc M WALL Z' LEDGES ELEVATiog of LhKE SIDE OF 40USE.FRCI0 LAKE STALE ' ..�onbe►vis� des of honfei I im Vale) i QI'4 LAKE Poo .. MUM SIDE MW OF NocSE: StALG %g "- 1' [to cAE w - r e [111 I :7i INNE Now I lljlll� I FrOJE U/COWCAM 14 LEDGE I9'4'' -3 ►. P&E LAKE 47.5TMf 11T, c "N 19'h" coeFeTE lak LL LEDGE 81 At iK �;uang rlG y FVOflPLF(N o Al" Z3FAMS+TAussf$ 0"e tRrA OF BASEM6N T - AffROX• 5�o►�E i�=1 W/rIL s�Enff� 1 vTAAryook i4 NOTED �t tEiuAG WITH l A o 6ajtt� l DOES. 6, I �^ to ;nbrlockd ' lOu IODUl :. DOORS 1 1 T4 ROCK b Cogtc M WALL Z' LEDGES ELEVATiog of LhKE SIDE OF 40USE.FRCI0 LAKE STALE ' ..�onbe►vis� des of honfei I im Vale) i QI'4 LAKE Poo .. MUM SIDE MW OF NocSE: StALG %g "- 1' [to cAE w - r e '' j Aq 4L .1 i vt .1 i ..... .. .. .... ' ` fir. &I A f. 1A ,7 7 77, _r.: :M .� _........__.... - - =�., _ _•_^__- _.�.�_^ _._.. _._..__......_ ...E ....._..._._ -v IZI- Al MAP 6 )(('ST*'j t4 O'C ► 17, 64, M AT PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please printotype -.... .... _ .. _. _ . _ . PPHD Permit #.. , ..r.•2� •. Well Location: Street Address: Town/Village Tax Grid # ,12. AIALER DRIVE NrNW jir1,1ic Map61; IS Block I Lot(s) 55 Well Owner: Name: Address: - Ar". LA X PVrNAM V4l-I ->~ N4-1 10511 Use of Well: ---U/ Residential Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield 56ught 7.0 gpm # People Served Est. of Daily Usage gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason . �� L — Lot;; 14z-D v� for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ................ '................ ............................... Yes No Name of subdivision N Lot No. Water Well Contractor: rl I f3 Address: Is Public Water Supply available to site?................................ ...................:........... Yes - No Name of Public Water Supply: t Town/Village Distance to property from nearest water main: i L(. j Proposed well location & sources of contamination to be provided s ate sheet/plan. Date: I b '3 0 Applicant..Signature: _.. :._ ................ . ....... 1 PERMIT TO CONSTRUCT A WATER WELL This permit to construct. one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and 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 or their designated representative 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. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to. degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue 10 1'!> 101 Permit Issuing fficial: Date of Expiration I I I o Z n Title: iu Permit is Non-Transferrable White c y - HD file; Yellow copy - Building Inspector; 5 i a� Pink copy - Owner; O ange copy - Well driller �L� Form WP -97 PUTNAM COUNTY DEPARTMENT 07 HEALTH ➢DI[6'I5HON OF lEfliVdIIPON1bIIEN'll'AII. III[lEA]C,aH S]ERVIICIES APPLICATION ION TO CONSTRUCT A WATER WELL please print or type PCHD Permit # Well Location: Street Address: TownNillage Tax Grid # 17 A2 RL l; A D EWE F LnNRM VA4FJ Map Q7100 Block i Lot(s) 55 Well Owner: Name: Address: RN N 1fg-2. Lk)( is �2pru� -4 bZV1; P0TtqP(M'Vft1- (Q1 ) Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation I- primary Business Farm Test/Monitoring Other (specify) 2- secondalry Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served I Est. of Daily Usage gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason '1 4 {-o 4 e.UEll w,11 S L ova la f fio wk dc�f 'Zve e-q o v .� 1�� .4�� ti -- 'MA"r for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No i/ Name of subdivision Lot No. Water Well Contractor: Noym Address: Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided o se p ate sheet/plan. -Date.- Applicant Signature-. PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and 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 or their designated representative 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. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration e 1 of the approved plan requires a new permit. Well to be constructed by a water ller certified by Putnam County. Date of Issue I Al Permit Issui Official: Date of Expiration Title: Permit is Non -T: ans4abie White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 ^• F ":tfi ...N':: .::,Arc. ..4.. x....•1,7 � 1� �:2'�..1 PUTNAM COUNTY DEPARTMENT OF HEALTH i DIVISION OF ENVIRONMENTAL HEALTH SERVICES _ APPLICATION' TO CONSTRUCT A WATER WELL ��-k please print or type., .. PCHD Permit #.... -l� i Well Location: Street Address: Town/Village Tax Grid # 12, A 2 ft L t~ R D E1 Yt F Ln N W VA4 Map Q19 Block J- Lot(s) , Z)V Well Owner: Name: Address: a(A N 1ffe- LNc ( I �Lj�-fl Use of Well: Residential Public Supply Air /Cond/Heat Pump" W Irrigation 1- primary Business Farm Test/Monitoring. Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served ,: Est. of Daily Usage _gal.. Reason for Replace Existing Supply ''Test/Observation Additional Supply Drilling New Supply (new dwelling) /Deepen Existing Well. Detailed Reason w af1i -bp 4etoeA wt1 t -sn G,.vi t f to wk,,f k( blve e-�)O v O InI?v.fA }v W%� ti 1' \�n SJIM r u,< for Drilling Well Type a,✓ Drilled Driven . Gravel Other Is well site subject to flooding? .................:............................... ............................... Yes No Is well located in a realty subdivision? ...................................... ............................... Yes No V Name of subdivision Lot No. Water Well Contractor: NOYM An r .(, 041'' Address: Is Public Water Supply available to site? . ....... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on -par ate sheet/plan. w _:_. J.� ; .. Applicant SignaW,Xd _... :_ . _ _ __. _: ilr .:o: _ :_ - - U PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth.above, is granted under provisions of Article 10 of the Putnam County, Sanitary Code and 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 or their designated representative 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. 3) Submit a Well Completion Report.on a form provided.by the Putnam County Health Department. During all well drilling operations, the applicant and/or well'driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. 'Well to be constructed by a water we 1 ' 11 iller certified by Putnam County. Date of Issue -I" q Al Permit Issw*ng Official: Date of Expiration i / Title:'- Permit is Non- Transfe t able White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 I BRUCE 'FOL-PEV: : Public Health Director 'LORETTA MOLINARI R.N., M.-S.N.- Associate Public Health Director Director of Patient Serv"ices TYP APTKAP'kTT 01P T=ATTT-T A Geneva Road Brewster, New York 10509 Environmental Health (845)278-6130 Fax(845)278-7921 Nursing Services (845)278-6558 WIC (845)278-6678 Fax(845)278-6085 Early Intervention (845)278-6014 Fax (845) 278 - 6648 October 5, 2001 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Jennifer Lax 12,A;.,ralea Drive Putnam Valley, New York 10579 MEMO Re: Well Permit Application for Lax 12 A7nlpn T)r;up M Putnam Valley TM#.162.18--1 -55 Dear Ms. Lax: :This Department has -approved the well permit for a well at the above referenced address.. Please be advised that if site conditions and/or-site plans change 'and/or are revised, thereby" compromising the minimum required separation distances, siting approval of the wells must be re-approved by this Department. filled be required to be- sampled for the e parameters listedin.Table f Bulletin ST-19. All necessary Town permits for the installation of the well are required to be issued prior to well construction. Should you have any questions, please feel free to contact the writer at ext. 2157. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj cc: (T) Putnam Valley Building Inspector P, F] BRUCE' R:- FOLEY' Public Health Director AORETTA 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 (845) 278 - 6014 Fax (845) 278 - 6648 October 5, 2001 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 Jennifer Lax 12 A--alea Drive Putnam Valley, New York 10579 Re: Well Permit Application for La: 12 Azalea Drive, (T) Putnam V TM# 62.18 -1 -55 Dear Ms. Lax: ,This Department has approved the well permit for a well at the above referenced address. Please be advised that if site conditions and/or site plans change and/or are revised, thereby compromising the minimum required separation distances, siting approval of the wells must be re- approved by this Department. The'above welI'to-be drilled will be_required:to be,-.sariipled-for the parameters`li.�ted-in Table. l o.f.- Bulletin ST -19. All necessary Town permits for the installation of the well are required to be issued prior to well construction. - -- __..__.._._.._.. . . Should you have any questions, please feel free to contact the writer at ext. 2157. Very truly yours, Adam B. Stiebeling Assistant Public Health Engineer ABS:cj cc: (T) Putnam Valley Building Inspector ..-;M 'U} S'ES;7�t1 ♦a� / ,I• • iliJYi is5• CS.. Li.j.3 ..1131 "ti.S u :L Bh',2G,E-,e hereon. j (,j 6 '- c- - \,•� .i _ � � 1 ' - ". %��82 - "� ti - t"U� . —..� /f- .+rte /S G"v /.0 _ 7 .i p{ E.J/is.C- .T siYO/t.CV iY.eiE-G.il B'-�•C/6° G of X - �.!! .sue �t/flli9il! ccvvTy C,C.E.�.� S q C. . �':: 5LjtVEYEO -AS IN POSSESSION. .. _ . f POSSESSION ONLY WHERE INDICATED. ?•. E " ENCROACHMENTS BELOW 9RADE. IF ANY. _ �uR Y NOT. SHOWN HEREON. _.... _ _._OF PROPERTY CATi-:D IN 'THE •..MADE IN COMPLIANCE WITH -THE - - -� - " U ' �T J T 7 {�V J. ".yY IL 6 U R IRISH INSTRUCTIONS OF. AND CF.RTIFIEG TO TOWN:-OF 1 U L `t l.�_; �` ,[�I_.l E 1 L eF. 3 L \ � 544YE1'OR f n �.' f - - - -. PUTNAM - tC..)UNTY, - 906 ._ =tj`ST., P�:,E'KSKILL. N. Y. , N. SCALE: I. . DATE. .�,CY, FILE, ,3�.3_ BOOK iCv'Q�i" P.':Gfi ZIS ? ,vision ofyEnviro=ental Health 3erv1c, ,pproved as noted for conformance with s, 1 °pplicable Xles and Regulations of the Co 1 Deyartment.. -- • +anature R T +rio��r,� TM's. a 1 , is