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Home My WebLink About4281DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.83 -1 -11 BOX 32 04281 is Ilk go is „F L Is IL i �1. - ` ti.._ 04281 r PUTNAM COUNTY DEPARTMENT OF HEALTH �A DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A W ATER WELL. piease pr t ri type Well Location: Street Address: Town/Village Tax Grid # v f 3'4 0 Fli 0 t. & 5T- C-k , 7C.f, QCs (-% LL- Map 'dock ! Lot(s) Well Owner: Name: Address: C A GLi o tTi�3 S�1 -v,.i As ►�4 i3 o vE e of Well: Residential Public Supply Air /Cond/Heat Pump Irrigation 4 rimary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought /0 gpm # People Served Est. of Daily Usage j:4Q gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason ,,v W,4x - (oaA. DYL - Ds G 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 Lot No. Water Well Contractor:- N -A)GAS Address: '? w�-0-PK VAh-uX'-( Is Public Water Supply available to site? .................................. ............................... Yes No ✓ Name of Public Water Supply: Town/Village Distance to property from nearest water main: 1 I'U w —rc % M' i LE Proposed ell location & sources of cont 'on to be p ided o eparate sheet/plan. _. Date:.. Q, 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 of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue 9' d �'' Permit Issuing Official Date of Expirati9 O Q Title: Permit is Non- Transferfab* White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 % 7 4 o % PUTNAM COUNTY DEPARTMENT OF HEALTH a /7 t5 D D DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL a�cenceRcz P.CHD Permit Well Location: Street Address: Town/Village Tax Grid # F3 `3 q 0 —p-�0 ( —E Lk,? (z ,&Vj(.1.._ Ma i Block Lot(s) 1 Well Owner: None: Address: 'C4 C� 0 S 1 1�6 3 0 (�4 01,6— Lt, 1`537 Use of Well: 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 Sought 69 gpm # People Served Est. of Daily Usage `Z-o4 gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason S-r-1 e.JC -L-L— �F 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 Lot No. Water Well Contractor: 4\T-J7t 0A-S 6 n! Address-'t4 , \ &u Is Public Water Supply available to site? .................................. ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: i�i`tf1= Proposed well location & sources of con to be provided on separate sheet/plan. Date: 3 0 ( t� 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 of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam County. Date of Issue 3 f 0(0 Permit Iss n� Official Date of Expiration Title: Permit is Non - Transfers able 06 White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 �4 BRUCE R. FOLEY .. ;�' . "'1?ublio �• Heailk� � Dire:,for' . 4 � - -- � `•�� , ^_. �, LORETTA MOLINARI..RN. - "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 ADDITION APPLICATION (RESIDENTIAL ONLY) STREET,31 OL o ", 5;7'- • TO 01' P6,5�K54U TX MAP #'W J3- 1-11 itra wt VA y) NAMEZ HONE 5 qS S ;( $' MAILING ADDRESS 3 DESCRIPTION OF ADDITION 1S`. _._-- - - - - -. - -. -- NUNIBER OF EXISTING BEDROOMS-3 PROPOSED # OF BEDROOMS 3 (FROM CERT. OF OCCUPANCY OR CERTIFICATION 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 Putnam County Sanitary Code: Please subiflt th 5'fofin'and'the following to Putnam CbEty- 7881tii Dept ., -4- GenedaRoad;`Br_ewsier; 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 4) Non =pro essional 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. OFFICE USE Comments Feb98 BFhouseguidelines -. . BRUCE, R. FOLEY LORETTA MOLINARI RN., M.S.N. &blic ilealth, Associate_ PuShd 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 p Re: .:Residence-- - _ - _ -- -Tax Ma �6 , ' `j. , l ._ Map _.... _ Town Gentlemen: According to r cords maintained by the Town, the above noted- dwelling IS NOT' - - in compliance- With Town code and the total number of bedrooms on record is - - -- -- — - This information has been . obfained from: - =- CERTIFICATE OF- OCCUPANCY: ASSESSORS RECORD: OTHER Buildi speclpr BFhouseguidelines ` Public Health Director . . ,...s:� f, .; LORETT [•. M®L JAR-1 ,R:N'.j <MS.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) 228 - 6108 Fax (845) 278 - 6648 July 27, 2001 Roy Cagliostro 34 Oriole Street Lake Peekskill, NY 10537 Re: Addition - Cagliostro- Oriole Street No Increases in Number of Bedrooms (T)Putnam Valley TM #83.83 -1 -11. Dear Mr. Cagliostro: 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 form this Department dated July 26, 2001. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at t ee without prior approval _ by, this department. 2. 'TTie area of the exisiing sewage disposal system,'and its e _xpansion 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. 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