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HomeMy WebLinkAbout3906DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.16 -1 -50 BOX 30 03906 P LORETTA MOLINARI Public Health Director DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive 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 July 2, 2004 Conklin 16 Brookdale Rd. Putnam Valley, NY 10579 Re: Addition — Conklin, Brookdale Rd. No Increase in Number of Bedrooms (T) Putnam Valley, TM #83.16 -1 -50 Dear Mr. Conklin: 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 approval stamp from this Department dated July 2, 2004. The addition is approved with the following conditions. 1. The total number of bedrooms must remain at three without prior approval by this Department. 27 1'he aiea 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 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. ML:lm cc: BI (T) Putnam Valley Sincerely, Michael Luke Public Health Sanitarian n 4 , BRUCE R. FOLEY Public Health Director DEPARTMENT OF HEALTH I Geneva Road Brewster, New York 10509 wq—*@ Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (945)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 ADDITION APPLICATION (RESIDENTIAL ONLY STREET E06kIJ Alf TOWN TX MAPS NAe �a Ia 1 [ an PHONE _t ,�PCHD# MAILING ADDRESS / m-0 1 kjQ E , o DESCRIPTION OF ADDITION NUMBER OF EXISTING BEDROOMS_ PROPOSED # OF BEDROOMS 3 (FROM CERT. OF OCCUPANCY OR CERTIFIGATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the. .....�.., .o - . -. -. >�. .. - �..�...�..... _ . LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Please submit this form and the following to Putnam County Health Dept., 4 Geneva Road, Brewster, NY 10509, Phone 278-6130. 1. Certified check or money order for $100.00. . 2. Sketches of existing floor plan (drawn to scale, all living area including basement) *Non- professional sketches are acceptable. 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map 9) *Non - professional sketches are acceptable. 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Cert. Of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFF7CE USE Comments F698 BFhouseguidelines 11�. b 'FOL'EY * ' Public Health Director 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 (845)278-6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Gentlemen: Re: —//a jeb , Residence Tax Map V; f e- Town to 11% - According to records maintained by the Town, the above noted dwelling 'IS IS NOT in compliance with Town code and the total number of bedrooms on record is 3 This information has been obtained from: CERTIFICATE OF OCCUPANCY: RECORD: ASSESSORS RE C .@ .I_ ' uildin Ins ctor BFhouseguidelines ;, l�z- -- ---- -` s° 1 ' . G� W —rO z z j Ole iZi ` ( All f Fi �k to 117 s F k? M e{ "AM CDUIJly QEPAH7 1E tT OF . HOUSE PLANS APPROVED FOR HEALTH BEDROOM COUNT ONLY; --"--,-BEDROOMS S►atu�e 8 Title !��"'' 7/7 Date w 5(l � cwt PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR- BEDROOM BEDROOM'CWNT ONLY; -� BEDROOMS ature $ This LAJ 11 LORETTA MOLINARI Public Health Director ROBERT J. BONDI County Executive 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/Prescbool (845) 278 - 6014 Fax (845) 279 - 6648 Conklin 16 Brookdale Rd. Putnam Valley, NY 10579 Dear Mr. Conklin: June 30, 2004 Re: Addition — Conklin, Brookdale Rd. (T) Putnam Valley, TM #83.16 -1 -50 I have received and reviewed the plans for the proposed addition at the above- mentioned residence. The plans indicate that the proposed addition will consist of.the_.f Vowing. Adding a bay window and eliminating a bedroom. Based on the information submitted, the above - mentioned addition cannot be approved for the following reasons: 1. Floor plans for the entire house, including basement, have not been submitted with the application. If you have any questions, please contact me at your convenience. ML:lm Sincerely, c C�_e Michael Luke Public Health Sanitarian F ttq L,/ ILI pP�� � Fi 7�k tt c��z����ac_ C-: D I I 10 IT a•: DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 Keith Conklin 16 Brookdale Putnam Valley, NY 10579 a z O,tM • .—< - BRUCE R. 'F&EY. R.S. Acting Public Health Director November 22, 1996 Re: Proposed Well Conklin 16 Brookdale Rd. (T) Putnam Valley Review of plans and other supporting documents submitted at this time relative to the above - captioned project has been completed. Comments are offered as follows: 1. Please find enclosed current guidelines for a well permit. Complete as required. - Tjon rice t of •a s abrapsion; °rewed-to rcflect`the abovd, `this � appfi`ci on' be consi&reii" further. truly yours, V �� Robert Morris, P. E. Public Health Engineer RWjp watershed DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 (914) 278 -6130 APPI;ICATI'ON TO 'CONSTRUCT,-A WATER 'WELL' PCHD PERMIT # WELL LOCATION S rest Address _ Town Vill g �- ck �. City Tax Grid Number WELL OWNER ame KL Mailing Address ., _ - a' _ (�,�� �ivate O Public USE OF WELL 1 - primary - secondary DENTIAL ® BUSINESS ® INDUSTRIAL O PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION 0 INSTITUTIONAL O STAND -BY D ABANDONED O OTHER (specify AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE_�al WREPLACE EXISTING SUPPLY ® TEST /OBSERVATION CIADDITIONAL SUPPLY ❑ NEW SUPPLY NEW DWELLING ® DEEPEN EXISTING WELL ST/ KJ b j REASON FOR DRILLING DETAILED REASON FOR DRILLING f}-HJ� ! U _ ` 0 w `C C- Qs- v r c—L i GU/ C L.,./ WELL TYPE SDIELLED ®DRIVEN ODUG OGRAVEL OOTHER IS WELL SITE SUBJECT TO FLOODING? YES. IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name -6 C by -CuL, A r V(l' Address 4a I (- �' S ±, IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES 4.-�O NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO- PROPERTY FROM NEAREST WATER MAIN:..-. LOCH ION SKETCH & SOURCES OF CONTAMINATION PROVIDED r []ON SEPARATE SHEET `l Z (da ) (signature) PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within 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 drilling operations be contained on this property and in such a manner'as not to degrade or otherwise contaminate surface or groundwater. Date of Issue: 19 Date of Expiration Permit is Non - Transferrable 3/89 19 Permit Issuing Official White copy: HD File Pink copy: Owner Yellow copy: Bldg. Insp. Orange copy: Well Driller LORETTA MOLINARI Public Health Director 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 Interventlon/Preschool (845) 278 - 6014 Fax (845) 278 - 6648 Norman Anderson, Inc. 152 Barger Street Putman Valley, NY 10579 September 23, 2004 Dear Mr. Anderson: ROBERT I. BONDI County Executive Re: Proposed Well Conklin 16 Brookdale Rd. (T) Putnam Valley 83.16 -1 -50 A field inspection was conducted on the above referenced lot by Brian Stevens, Public Health Technician. The application to replace the existing well is approved with the following stipulations: 1. A minimum casing length of 40 feet is required. 2. The existing well is to be abandoned once the new well construction is complete. Please provide notice to this Department five days prior to abandoning the existing well so that this Department may witness it. A Well Completion Report (WC -97) shall be submitted no later than 30 days after the well completion by the permittee. . Please contact the writer at (845) 278 -6130 ext.2235 if you have any questions. Sincerely, �. X Brian R. Stevens Public Health Technician cc: RM, file Mr. Conklin PUTNAM COUNTY DEPARTMENT OF HEALTH o IVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL. please print or type 9 .u.. - a _ PCI ID Permit # IA% . ,2 =f; ..w :_: :.z• Well Location: Street Address: Town/Village Tax Grid # (� v ct - Kc P, I , ki tL i c ; Map 3, I (a Block J Lot(s)510 Well Owner: Name: Address: J k6d 1, gd-LA< J a. Q 4iQ l 1 f 0 aS Use of Well: -Residential Public Supply Air /Cond/Heat Pump rri ion 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 _g Replace Existing Supply Test/Observation Additional Supply aDrilfling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No ................... Yes No Is well located in a realty subdivision? ................... ............................... a/ Name of subdivision Lot No. Water Well Contractor: Accle r -,-"b u... W _�J 9( dress: kc, eV .................. ............................... Yes No Is Public Water Supply available to site? ................ cf Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. :Applicant Signature; -. PERMIT TO CONST UCT A WATER WELL TN§ penpit to construct one water well as set forth above, is granted under provisions of Article 10 of the �P>itiam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided x`tl& thirty (30) days of the completion of water well construction, the applicant or their designated f 6senlave shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the �!Qe rements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form Jpr�.ovided$y the Putnam County Health Department. During all well drilling operations, the applicant and/or -.. �: welldriller., shall take appropriate action to assure that any and all water and waste products from such Ifdrillft operations be contained on this property and in such a manner as not to degrade or otherwise Wntamirzaje surface or groundwater. Lai t..... -, 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 war a dril certified by Putnam County. Date of Issue q 12,2,1,9 Permit Issu' fficial: Date of Expiration � Title: Permit is Non -Trans ahl White copy - HD file-, Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller A, 7- ® Form WP -97 I A4 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO ABANDON A WATER WELL please print or type PCHD PERMIT # Aw `36 —oc% Well Location: , Tow//nNillage Tax Grid # Street Address:� nn Rj. V�Ittt Mapd3jt Block I Lot(s) Sb Well Owner: Na e: Address: Well Type: Drilled Driven Dug Gravel Other Depth Data: Well Depth ft Static Water Level ft Date Measured Use of Well: Residential Public Supply Air /Cond/Heat Pump Abandoned 1- primary Business Farm Test/Observation Other (specify) 2- secondary Industrial Institutional Standby Water Well ame: Address: Contractor: �> D Reason For Abandonment: Y Description of Work To Be Performed: y i Date: b Applicant Signature. ECG PERMIT This permit, to abandon one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code, Subpart 5 -2 of Part 5 of the New York State Sanitary Code and /or Part 75 of 10 NYCRR and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall submit to the Department a certified statement that the inflation del.�heated on the application for this permit has been completed.' . 'q /z,3 A v Datelof Issue Perm' Issuing Official Title White copy: HD file; Yellow copy'- Building Inspector; Pink copy - Aner; Orange copy - Well driller Form WA -97 1t * PUTNAM COUNTY DEPARTMENT OF'HEALTH DTI'JOt�T H?TL�CES4 _:.: >OF.N��lJR1!NtIE.d7C: FW : YO FIELD ACTIVITY REPORT }�TAMA N c1TT)RF:.C$.Y Street Town State: - Zip , PERSON IN CHARGE AR Ti�TTFRVTFWF.T� Tate r d Tame an Title TYPE OF FACILITY: i. FINDINGS: F - - a.7 ,x , - - - 3 r ti- k - k y r � JJ 4 $ 4 9 `Signature �and� Title. REPORT RF,( F.TV--FD RY: I acknowledge.<receipt 'of this report SIONATURE;± a Q2%96 Title, e r�° SA n G l� ► r C D S2 7 7 .6 r D O 1� �G le ct � ct' o 6,e tC4 C e .'C ,. -r .- ....tea -,. - -,., .,� � .... _,.., --•- , a.•-., ,.>Q,._.,_,� ...:.- .. _. s _,. :.�- _ ,.— .� : =,..., 1 h P X f r a fP a (SO n,,.+1 --=2SEr-� —1 V/, � eo �_C�d T� �C- L /00 o� G L SPl 1, 7,r-.., /, Cow TraC. Oar eboo A4A1 5,2 -��s ✓s 10 Y, d1o�P : M, To sc. L e. Work to start ............... � .Permit .................................................. ......... ............. ..��- .....,.. :K. = paPth.. Pear ............................ ' . ... tAGE • ................... ........................ >�........ fRON ........ TEL ........................ . . t. .....` ........... U ADDRESS "" Dimens1on of Stories LAND Depth ROOFINv paved Shingle Dirt Shingle piled a Swamp ,dal Brook . -'. F --j—t41—E—VI0R Ro° Apt. R°oms ppT. Attic Open Attic Finished PORCHES x Si�e XRear X Dams Sw. Pools Ton, courts .,TUER BLD;— Shacks cottages Electric phone Width Type foundation ........................... ....... . .......... . ........ Size 8► Use Each .................... ....................... Room with W ind°w Area ........... ......... Sewerage Type ............. ... .......... ............... Size of Septic Tank ............................. I age ............. . Ft. Dr .......... lineal ................ Wells ...... Size of Dry .......... bin9 ............. ............. I Plum ............... 11 . Description .............. W all t,AISC. Description ...... Furnace ••• .......... Plot flan eq ................ olio^ privew °Y ecifications and aU inform lete Plans, sp by inspedor. comp ........_ ................... when requested Estimated �.. ................. and urveyor s map V u., t S ,EY No 8i -6344 ~� ;t Work to start at once J N284- 7357 - --�— 85 -0 4 6 8 '- 6344 - 5/25/82 4 a copy o4 'T s of Putnam . � Code of the own ' .... , . � .. .- .:.... _ . - .... Area.............. lr.q...t..................... Total livable �� 1 I,onin9 Board APPrOVaI ................. Date �" ................... �adtiws having - -- /� 1�d°�`' Sanitary QO t, having �p -Ctsi zs Ja- ned that N- r ---�1� ��� ' Id struc- �j� n ` 'd . work S� ' 's have Now, r -- ----- utnam ORK b r4 ._..eons and all information required requested by inspector. Total Livable Area Estimated Cost $ — ,..tubing Date Zoning Board Approval One Park Way, Upper Saddle River, NJ 07458 -2311 (201) 818 -5900 FAX ■O.E��O - \V` > .a srA?. 4 �. • - ..[nY C F' i ...-. yam.. -a TO: Linda Putnam County BOH COMPANY: FROM: Mario Schiavone FAX NO: 845 - 278 -7921 PHONE NO: DATE: 08/06/2004 NUMBER OF PAGIF &I !CLUDING'THI PAGE. 1 To Whom it May Concern, Please be advised that I am the homeowner at 20 Brookdale Road, Putnam Valley, NY 10579. 1 hereby grant Keith Conklin permission to cross my prop- erty with well drilling equipment for the purpose of drilling a well on his prop- erty. Should you have any questions or require additonal information please feel free to contact me at 201 - 818 -5900 x229 during working hours or at my home at 845- 528 -7599. Sincerely, Maria S ' iavone 4_ 20 Brookdale Road Putnam Valley, NY 10579 C Cn OD Return FAX No: (201) 818 -5904 Transmission Problems: (201) 818 -5900 FIED TO: SECUP /TY T /TLC G!/4 2gNTY CO. R ' ULSTEre SAv /ivGS ,BfJN� E .STATE OF w Y "Ore.0 MOreTGfl GE A6.E"NCY DRDANC.' WITH THE EXISTING CODE OF PRAC- R LAND SURVEYS ADOPTED BY THE NEW YORK SSOC. GF PROFESSIONAL LAND SURVEYORS. C. CO/YrCY. //V t! S //VOEE A' f 3�lV Fi' - MACH /NE CO, /NC. \ I A/2EA = 13,766 O. 3/G qG. ications shall run only to those individuals and institutions hereon under the titlu policy No. shown above. Said certi- ns are not transferable SURVEYED & PREPARED BY BUNNEY ASSOCIATES' LAND SURVEYORS VOOOSBRIDGE ROAD ROUTE 117 KATONAH. NEW YORK 10536 _ I Iv i a 7. V 6.30 m O /r2T O GRRRGE � 1 l), � `� • OQ /`E UN06Q I � wi a hOCJSE I d n, • 41 o � � _ 1 w (!� ,36.60 I-"y METF7L i /6. raj 41 s /Y 71 /S 4S'!�/ NEOCE /B2 e9 L oN ore /VA.PO ¢ `S. }I. SCiC�FlNEV A. !A' N �-1,4 0 1 5 .I SURYEY OF" pROP��T -Y I S /TU q T,E /N 7OWN Op ,PM C O U AV 7 i. NEVI/ YOR.0 SCA.L E i• �.2E.oAREO o e .t'E /TN C CO/Y,C.L /N S /N©E.E R. N.15// —,50" S {;RVs : -'i :'.AS IN POSSESSION FILE No. T676, ,r - ._— . • Vii. e I: i• 'IEO RDANCH NIIH THE EXISTING CODE OF PRAC. LAND SURVEYS ADOPTED BY THE NEW YORK SOC. OF PROFESSIONAL, LAND SURVEYORS. Er C. //Y 5 V, 9--, .v.kl 0/�e 7' Q) 4. N gas %4 (I -1 . 10D 4-1 4PO ,Z IC 11 TORY t :HOUSE 71 - 1.5' t4 ;ro f4. OR 5-lvv thereof only if said map or copies bear the im seat of the surveyor whose signature appears h Co, /NC. 11&76q 30. PF POSE'.. N r oG v))M 0 0 7.11 /7'43' 05-kV 16.67 AT EMN I TH AS TORNF-Y bmam" 'dam P4 o 7N,4A*1 YWL L UWN COV411, COON 7"Y 'At—Z-11V s5r S 11V`0,5,F R. FILE No. 7-676, ='13,766 5.,,o--- sl rations shall run only to thoitj individuals and institutions iereon under the title policy', oi shown above. Said cerfl, SURVEYED & Pli FSPARED BY BUNNEY AS§XCIATES LAND'SUR YORS 'OODSBRIDGE ROADk ROUTE 117 KATONAH. NEWIYORK 10536 tg itd gas %4 (I -1 . 10D 4-1 4PO ,Z IC 11 TORY t :HOUSE 71 - 1.5' t4 ;ro f4. OR 5-lvv thereof only if said map or copies bear the im seat of the surveyor whose signature appears h Co, /NC. 11&76q 30. PF POSE'.. N r oG v))M 0 0 7.11 /7'43' 05-kV 16.67 AT EMN I TH AS TORNF-Y bmam" 'dam P4 o 7N,4A*1 YWL L UWN COV411, COON 7"Y 'At—Z-11V s5r S 11V`0,5,F R. FILE No. 7-676, S j J JJ Dr qyk I I IV . c: lip yam'. V a