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HomeMy WebLinkAbout3427DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.17 -1 -38 BOX 27 1 ro :1; J16 ' �� v ', - ' ti '' �� I' r! 03427 41:7,0^1 N� ITA, N WIN 173- PRI121, At Well ACK, AM a, qy-'P"VgfN,`I0 um rgn q�, e c 27 Rai NMI IR11-1161, HIM, an ,� L", �A W n 1-� "Y. kd 0Di Division.,, f wrmw!-RN,,, 4,10512. g Yvijfi�',R ,APE A k I* - SMSTEM Al 4Z "A AX 'wiTown,75 i5ge 7��V-,I 2 "N' 'M liM, W,,',5Ubdivision;;,, g bd rLdi L U'AA-rea-, IF M. 5q re Number of e r !.!i !,'o'-a the 5 be, 'I KA 77 i�rh ' ' i h � .t�enc L pies tof which :are :,c 777 =s� �z WELL COMPLETION REPORT 3/71 ' PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services ' COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed by well driller and submitted to County Health Department together with laboratory report of analysis of water sample indicating water is of satisfactory bacterial quality before certificate of construction compliance is issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME �() L ADD SS l 27- L LOCATION OF WELL (No. 8 Street) (Town) (Lot Number) PROPOSED USE OF WELL BUSINESS IC?DOMESTIC ❑ ESTABLISHMENT - ❑ FARM ❑ TEST WELL 11 SUPPLY ❑ INDUSTRIAL ❑ CONDITIONING ((SSpe if ) DRILLING EQUIPMENT COMPRESSED CABLE F] ROTARY . AIR PERCUSSION 11 P PERCUSSION El ((SSpecify) CASING DETAILS LENGTH (feet) r� DIAMETER (inches) f) WEIGHT PER FOOT ( © THREADED ❑ WELDED jDBI E SHOE Y� YES ❑ NO G L YES NO YIELD TEST ❑ BAILED ❑ PUMPED ®` COMPRESSED AIR HOURS G.P.M. YIELD (G.P.M.) WATER LEVEL MEASURE FROM LAND SURFACE— STATIC(Specilyfeet) DURING YIELD TEST !feet) Depth of Completed Well r• in feet below Land surface: �L,o MAKE ILENGTH OPEN TO AQUIFER (feet) DETAILS SLOT SIZE DIAMETER (Inches) _j_IF GRAVEL PACKED: I Diameter of well including gravel pack (Inches): GRAVEL SIZE (Inches) FROM (feet) TO (feel) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET 1 enia. . ��... .. .. �4. -�:r -. r.a. .. .. •-,, �;nwa.,,: r. f. ,, v..,`. :';'f• - -• •_- h/9 r :zap f 2� c s✓ �. If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE .b - -. .i ." -,. °'�.. ... -..v Y ,. w: .,- ..ti.,.. A.y:...1 .. ...,. ..'`^'. DATE WELL COMPLET D Q / DATE OF REPORT I WELL DR_�LER (Signs ) ­­1 J. r Bui d; C - - � �10n Z, d -b1O - J Lre5- Z, BlOC''f LOZ GU I s.- ._:- ._s.. -..c ....�..v... :,.- ,;.fi_.�..a'xa.. -- r,.� _ _ ..._�. ..�..�._ � - .....�a,.,•,o..:. «...x,..�aa..s ....._:3ra .^6.� -- .•_,�.o.... ..... . Jv` >j.. -__._ - -� J ] ^ -__ __ _._l.- ._ ^_- ..�_._ -- ... •. ter_ _, i --- _� -�_. ___..aj.� .^i_- � ": �. '�� .- .J -.'� —_. � _��`•'�•'"h --�- `�N... �J l -� - Ct _- __ _w - - - T ===-= iii ����= - =�.. __._ _._ - -_ �� :_ _ - . == Z•. ,��-._ - - - -._ -_ __ C�� ` -� -" - = Q = _ _. = �:_ __ `� - �=_ -. -__- �� i vim. __� J -. - - -� =-- � -_ � �....= ..• - -=- s � �� .�.r �.�.. V T� _ s.- ��: v: j.- 1J •`.,�''"`- "�..'$•- r�?- ���:.•.i` 1ys.r._� >.1� _l'x _ -w�•'• •.ta...- -.. ..-:% -v+ t= .yv�vi�Y� ,.-..0 _,y Tr,.!!i -� _ _.�•.•_�Y r._.. 1r r _. r r r r r _ r r _ r •— —. — r r _ r _ r r — —. —. — — •- — — D_•Trl s_0:.1 Q_, v:� ?. LZ nab r a PIII'N_ -?I COIT?';TY DtEP RTi� NrT OF 1EALTH DIVISION OF ENVIRO iI * =, T =.L r'ALTH SERVICES. Date Re: Property of UO L Located at This letter is to authorize a duly licensed professional enzireer /or registered architect �C ( Indica tz- ) to apply for a Cons truction Parrit for a separate. se:.a rag e system; to �.._ .:.....m y ...b _- .c,.._ _... s ..tea_ .....�._... .�... �•... - -_- ..+s_,.. -n.a•_ '' .v :••,r, :ter+_.. -'. Y? "��n -�.. :'�'•; .1•`•;'^. -�,.. r�_ps?- i��.�•,.a.._..•,, '.�:.�.,,........ o�u��c��'r -oP� . .,j _Z =- .cco_,�___� or. re- 7ul=t_.ons as pry ul=--ate . bf t1n-, Co:'..__ssioner of the FutnTam County Dep��. 1t '' '-Health, �r..a t Gr1 1l J a. - r ^e- -n- G,-, =l L tr:. o 1 o siV. all nec ss _ r s on b _ in co?lt-i_ctiL� ! !i -ith this lat-4. _Ind ,to suoe vises the co:ls'ria- ion of sa- sy ste^i or s,:3L:;:^s ,ln confol -mivy .ilu t.. orovlslons of . "A 1^V1cIa 1,1: on. Ed z[1- on La,,..,, t- he Public Health LaT..*., . and the Putnam: Coun :y S n; 'tEiry Code. b ..., Very truly -o s, o5S .. KO`F ,� �\ S 1 F_12Z ✓v a�. zer of Property. � Countersigne �� t,,_ �. a i,:... Address as ty, Telephone e al ) A ddr s s� �:. ti / `°"`+ y".-: s. .�cn. ^�w.Aw�+nnoa.9.•'ay..w:G�• °,tom• � rt�s �`�'"y�vN.u.�y''''1 -fit" �.r'�''.�♦':.1 �':;;�'..rr.ye,w�s,.�.w.,.e SIHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF HEALTH 1 Geneva Road. Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY � o t l � ✓� 1 () C STREET L t TZ D. TOWN PVT VA k k1TAX IAA #_7 � • 11 m t �°� <q B�° 3V9�2z) A NAME �c N GG yt tkm c l-,� PRONE PCHD# : . MAILING ADDRESS (DESCRIPTION OF ADDITION NUMBER OF EXISTING BEDROOMS- 4 PROPOSED # OF BEDRO OMS A' _19T. -U. �DCCUP/°. _Cy I_�?I$- CE>!�TIF'''i'C 'I'$Ol? . n' 014 If T IL�dO.I1�1 pE' G T 1!�) _ _ * *Any addition"whidh isconsidered a„b * room requires %rmat approval of pians.(Construction permit), prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 1 Geneva Rd, Brew ter, NY 10509, Phone: (845) 278 -6130. .. vl. Certified check or money order for '$ $)- 00.00. • 2: Sketches of existing floor plan (drawn to scale, all Hiving area including basement, to be shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin HA -1) 3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #) Non- professional sketches are acceptable and preferred. (See Section 3:d of Bulletin HA -1) 4. Copy of survey showing all well and. septic locations. on the subject property to the best of your knowledge. Include date of installation known. Contact this office with any questions. 5. .Copy of Certificate of Occupancy from the Town or Certification from the Building Department with legal bedroom count of dwelling: OFFICE USE COMMENTS 5 • 7. �Envicapmenta[Health =184.5):L74- 61.3.0 .Fex. (845),278-792t Water Supply Section (845) 225= 5186'_Faz (845)225-.5418 Nursing Services (845) 278 =6558 Fax (845) 278 -6026 Nursing Home Care Fax (845) 278 -6085 WIC (845)278-6678. Early Intervention /Preschool (845) 228 -2847 Fax (84-5)2254580 SHERIHA AMLER, MD, MS, FAAP Commissioner ofHealth ROBERT MORRIS, PE . Director ofEnvironmewal Health . Nemec Design Group 215 Hilltop Street Mahopac, NY 10541 Dear Sir: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Office (845) 808 4390 Fax (845) 278 -7921 or (845) 808 -1937 Re: Addition- A- 024 -11 PAUL ELDRUGE County Ewcufve March 21, 2011 No Increase in Number of Bedrooms 33 Lincoln Road (T) Putnam Valley, T.M. 73.17 -1 -38 _ I iiae feceived tnd reviewed the plans f2ir thbpruposed addition�to'the °above= iirentioiied residence. The proposal for the addition has been approved as per plans bearing the approval stamp from this Department dated March 18, 2011. The addition is approved with the following conditions: I . The total number of bedrooms must remain at four. without prior approval by this Department. 2. The area of the existing sewage disposal system and its expansion area must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restrictors for shower heads and faucets etc. 4. This Department recommends you contact your Building Department to ensure setbacks and other current codes can be met. 5. The approval is -for the proposed changes only. This approval does not validate any construction shown as existing that has not obtained proper approvals 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 (845) 808 -1390, ext. 43261. Sincerely, 2Aa � Gene D..Reed Senior Engineering Aide GDR:cw .:� ccr 8;�('i"j'Pii�tif%Vey,a�_,a �s�.� .. -. •gam �f; „�,; �;• .., ;.,. :_= .✓u��, loo Sunnbro ,qg Travis MWSW d vtiW Cr Corners a I i I South Hight nd a.� g� zu Corn fi: e 10579 o n H II BrpO U ra, s�nr4 ke Cro OA ice Corne 0 PUTA AM V LEY y9 v hous �: �° useum Adams Corners s< RD x ose HiII Park ..e+ .a.r ..e.. pq ,r .. z...,.r .. r tifi� _ B� .! 1x G _ ... _ . "< - �eJn ^tea w• O .- . IYYI `� 15 _ E/ Oya Cem m rX POVff � _ Co tine nal �g s Villac ie g S. s g i u 6 eDDDK utnam ea uu AA �y :° L VALLEYp -Tt4a+M C ®v s alle , cou o�� o � r d I Bro so RD et R W . I .:��1 PE 1 ,: •• o Mohegai lake GM 6 Xg SHERUTAAMLER, MD; MS, FAAP Commissioner .0 f Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health DEPARTMENT OF.HEAL -TH I Geneva Road. Brewster, New York 10509 Town Lestal Bedroom Count & Proposed Addition Status Re: GREENWICH (Owner's Name) Tax Map # 73.17-1-38 Address: 33 Lincoln Road Town: p3litnam Valley Year Built:. 1978 According to records maintained by the Town, the above noted dwelling, Is XX in compliance with Town Code. Is not in compliance with Town Code. The Legal Bedroom Count it is: 4. This information has been -obtained from: Certificate of Occupancy: Q0#72527 dated .aLld/72 Other:, The plans for the proposed addition are considered: New Construction XX Addition to existing house only Teardown and/or re-build allowed urider Town'Regulations. 2/11 /11 loqil.d in g In p ktor Date. 6. .'Environmental Health (845• 27826130 Fax (845) 278-7921 b _'_'W_Xe','&S'd0PljYSectj n-(845)225- 5186",Fag--(845)-225--5"*418-'-'��-�- Nursing.Services (845) 278-6558 Fax (945) 278-6026 'Nursing Home Care Fax (845) 27*8-6085 WIC (845) 278-6679 Early Intervention/ Preschool (845) 228-2847 Fax .(845)225A580 A • - �, nl. T \Tp,�. 1tir:i 1 DESIGN' D.1% T-1 - _ - SAP; ^� SL:: _� �L ��SI�.. F E ,C rZ Add- e3s Lo c _c� (.� __ _ _ _ o� ��4 C /� _�%S�c Blac'. - - -' Lo J-,, �. ����nic pGli L / ,G Le- 11 _ . vVT✓ 7= pr+r -.r -. ^1`v \`• _,ST D:1T .`�=. J:. � �^ .,, 1: E:/ iTr Dr I •T Tr,)N Hoie ^0: Ci," I' - P: i ; PERCCL1 ?1_� R ?rt E1ar: Ti r07 ,- Oulm� LO C_ II:C. -._S JO' 1 _ .�_�: .t. S �a�, _ : �a `li... S k _r = Sto0 Dro Inch_s I-:c:-'e= S. s 2 5 tio�s. 1) Te s _j to i° °_te same G�O�a''.. L . `�i aD���'0: +:_...� =a�- ! so.'_l r- , r?J are oJ,-- tdineu a.i: ° all Q �O JP� ..�..._ = ��' Oi I'c%'� IL DPI ICATIO�- ITTED TEST PIT DA T, ?,EOUT� D—ED 0 2 7- S,; B DES CRT PTT n_y,� 0-- S .0 :1, S TV —7S— HOLES DEPTH HOLE G.L. 6 "G6 12" ,r r z4' 3,0:* 36' 42 49 5 4" 0 'o" - 66 7 2 " HOLE NO 8 4- I -ND, ICS 1.E rULEV—E, 1, AT WliMlil GROUND RIX -V TER 3'E-"-7'NG ENCOUNTE iND-ICATE TESTS BE- Date Soil Rate �i li 1 D L re n S. D. 1: Or .7 07 1 _e 2 o of a r. o o:-.s CODa___ 11-2 -r als Ily p _Septic Absorption `lreca Provided B L- F. x 2-" 3.5 t,, i dLh 7 trench. Othl-.,L,- S KUL 'f Address r SEAT v r A=e-?f LN L I i TKENT 0-0 HE" LTH PUT-AX CC"\,-Y DEPAX. Sq. Ft./Gc-l. C h e o'-,-e Ot 0,0 Soil IR, 2 o o r o -v e Da Le