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Home My WebLink About4688DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 91.24 -1 -20 BOX 35 I N.7%. 0 Is r r Lis !J6 ., Z so m I 11 r kP 0=1 m i . . mi PUTNAM COUNTY DEPARTMENT OF HEALTH �i / ti DIVISION OF ENVIRONMENTAL HEALTH SERVICES please print or type APPLICATION,TO_..._ ...,._... , .,,,. _•- .��.;-a.. '�:; -:.. �� -�:,. ;�.� -; :;:. ��.:� ,," .... CONSTRUCT A WATER WELL iPCHEe Well Location Street Address: Town/Village:, Tax Map # Block Lot(s) . Well Owner: Name: Aerdrest : PA��T�1 9�" G i Use of Well: Residential Public Supply it /cond /heat pump _ rigation 1- Primary Business ..Farm Test/monitoring _Other(specify) 2- Sec6ndary Industrial Institutional Standby Amount.of Use Yield Sought gpm # People Served Est. of Daily usage gal. Replace Existing Supply Test/Observation Additional Supply Reason for Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason for Drilling Well Type DoMed 'lYriven Gravel Other Is well site subject to flooding? ......:................................................ ............................... - Yes . No Is well located in a realty subdivision? ........................................... ............................... Yes Name of subdivision Lot No. Water Well Contractor• Address: f Is Public Water Supply avai able on -site - -Ye -- .. s - _ 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 separate sheet/plan. Date:... / . �g�. - 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 Countv Health Deoartmer 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 Commissioner of Health. 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 `�v `fir Permit s in g Official: I i ca D ate -of Expiration (a ---(G ` Title: f� %: / ; o.�,,.�,•cl, '- Permit is Non - Transferable White copy - HD file; Yellow copy - Building Inspector; Pink copy --Owner;, Orange copy - Well driller Form WP -97 Rev. 3/06 BRUCB • R...:..FQI 9Y . `''s `' ` Public � afth`'-Drector . •"- .. � - ` �' �sY7 �.' ; � _ Richard Meister 13 Laurel Rd. Lake Peekskill NY 10537 Dear Mr. Meister: :L TTAYMOI.WART.,_P- N�;,M.SP1 �;,. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH[ 1 Geneva Road Brewster, , New York 10509_ Environmental Health (914) 278 - 6130 Fax (914) 278 4921 Nursing Services (914) 278 - 6558- Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 September 27, 1999 Re: Addition- Meister Laurel Rd. No Increases in Number of Bedrooms (T) Putnam Valley Tax # 91.24 -1 -20 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_ September. 24J229 The addition is approved with the - following conditions: 1 2 -. 3 The total number of bedrooms must remain at Three without prior approval by this Department. ;Y The-area.-of .fhe. existing se j ;.qg -1 spQSal sys gTLand its ex nsipu :arm must be maintained. z 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. ML:kg cc: BI Very truly yours, Michael Luke Public Health Technician DEPARTNIENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 TeL (914) 278-6130 Fax (914) 278-7921 PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY) BRUCE R. FOLEY STREET —0 LAS, o2A • TOWN ?N-r -� TX MAP # qiY NAME AtA &M LPHONE S ��Z PCHD # MAILING ADDRESS 13 t W�u- RD DESCRIPTION OF ADDITION NUMBER 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 submit this form ana the following to Putnam County Health�Dept., 4 Geneva Rd., 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 #) * 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. OFFICE USE Comments i �� aSz��vfs lvt�s ei- S10 ILI r-S S4 0 Feb 98 DEPARTMENT OF HEALTH Division .Of Of Environmental Health Services 4 Geneva!' Road, Brewster, New York 10509 (914) 278 -6130 Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: Residence Tax Map Town Pwa�a~ Vi�ikrq Gentlemen: BRUCE R. FOLEY, R.S. Acting Public .Health Director 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: ASSESSORS RECORD: ✓ OTHER Building Inspector 1 ��.. r6. .S�:c c: � „' ro v � � •.. ?r .. .. w/. Wt r c r. n .•� •�t:;wiPft t• 'y'tyQCt�r. ~F.. o'-OV -N ♦i- L 4. (MI .. r � .�.r 7r! f' l PV pl �y _I A T- �E� Peo Cet6,ow% 7'7 ?AIM TA, A641 L-1 COOAA e- Ax, UY ,/— I — --,;I-o 0 L-4 -V e rk ad Ii ks I arc, go OAA 1 LI d u ��°i� — PUTNAM, COUNW DEPARTMENT OF (HEALTH HOUSE PLANS APPROVED FOR BEDROOM COI INT ONLY: 3 BEDROOMS r - 9 /2Y/ q Signature V Titie Date 'P010A, STAI a,( 7 t.11 ; t i" L :'i COUNTY DEPARTMENT OF HEAM HOUSE PLA.IliS APPgi)VED FOa BED CoLipjrf (I -3 Si i Ir - �ci--rfi ic ON .—Tif 7 Date FRoAT A—PA kO6 I- I Q 114 0, o.A 2 -4 �w eD rZ 3 a A 0 q 00 C'.4 QooM all I, 7; 9obj5 2IX31 3" TM q I 'A 71, 7 t.11 ; t i" L :'i COUNTY DEPARTMENT OF HEAM HOUSE PLA.IliS APPgi)VED FOa BED CoLipjrf (I -3 Si i Ir - �ci--rfi ic ON .—Tif 7 Date D. INSPECTION Date Z Inspector \'o evidence of failure ❑Evidence of failure ❑Evidence of seasonal failure ,r n' ef HOUSE rV - �" ': co ------------------------------------------------------------------------------------------ - - - - -- (1) Indicate location of SSTS A. Size and type of septic tank Ometdl OConcrete B. Type of absorption area 1. Fields ft. 2. Pits gallons OPlastic J. Gallies ft. '(2) Indicate setbacks; front street; backyard; acid "side yard "dlm* eensions (3) Show location of well (4) Show location of driveway (5) Note physical features (steep slopes, rock outcrops, streams /wetlands) SECTION E. EXISTING WATER SUPPLY.. 13PWS D/Individual ❑Shared well well Drilled ❑ D-Casing above gQrund 0 b CONi QvENTS : REPAIRS ONLY: Status: As Built Inspection Required: As Built Submitted: As Built Inspection Done: Inspector: PUTNAM COUNT'S' DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL INDIVUDAL ADDITION/REPAIR ]FORM SECTION A: GENERAL INFORMATION Name of Project I S I d (T)M TM# Year of Construction Size of Parcel SECTION •B. TOPOGRAPHY (Please check all appropriate boxes) 1. 19 ill ®Rolling ®Stee Sloe ®Gentle Sloe ®Flat Y � P P P 2. OEvidenceofwetiand ®Low area subject to flooding Bodies of water ❑Drainage ditches 01ock outcrop _. . YES NQ 3. Property lines evident? 4. Water courses exist on, or adjacent to parcel: 5. Existing individual wells within 200ft of the existing SSTS? L� SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) . 1. Physical character of existing SSTS area. A. ®Level Gentle Slope ®Steep slope B. ®Well drained ®Moderately well drained ®Somewhat poorly drained ®Poorly drained C. Area available for SSTS. (Primary & Reserve) xtremely limited []Somewhat limited Adequate ft x ft N1 18° 15 =50`E N2z°'3� -00 "� . o 03 80.43' I �e_ 183. $o' L.A OA' 'Y3i °o? E I'.. .. , y. _ a • v. t .... A . .a a. u ..a ., c R' 4 »` -tii .._. •. •. Y '• �...J 1 ' N• '�Y. •• j+•�+..... I T hn Sa/ualore fieo •O Orlc .S,x '' ., CE2T iFiEO 7,70.- in co . pe Piie Swi f //w»es '- Em to ax� tl is map cuaa comp /ekd oi� Ocr: � •'. • . .:.� �.... 15 1y43.. •. fors 5G q ro � 2 0/.- 6 /otk 48 �. • as sin, o f r»dP No..1&5C ei��iAed,y� LgkE s&IL4 .51-Cr /0U f kd •� 771E I �e_ 183. $o' L.A OA' 'Y3i °o? E I'.. .. , y. _ a • v. t .... A . .a a. u ..a ., c R' 4 »` -tii .._. •. •. Y '• �...J 1 ' N• '�Y. •• j+•�+..... I T hn Sa/ualore fieo . rJi)7o made .>'ilis 4r ap : do fi�irby cerfify ..:; ;',: '' ., CE2T iFiEO 7,70.- M&/ 1%e . Tt1v Upon u* h 1'h,s 117V 13 . based was •eomP/ekd ern Ocr s,194 Piie Swi f //w»es '- Em ax� tl is map cuaa comp /ekd oi� Ocr: � •'. • . .:.� �.... 15 1y43.. •. fors 5G q ro � 2 0/.- 6 /otk 48 �. • as sin, o f r»dP No..1&5C ei��iAed,y� LgkE s&IL4 .51-Cr /0U f kd •� 771E o /jce . 7f7c Cxny clerk ;E:bruom Co. :,' •. ' Game %: ifle� yor,E. ... ,:. - SURVEY OF PROPERTY � FOR' HAR.LE 5. G. SITUATE IN THE i JOHN SALVATORE ROMEO CONSULTING ENGINEER & LAND SURVEYOR iO�� O:f' RUTNAA4 �r�LLCY I, f 1 NORTHRIDGE .ROAD PUiNFi COUNTY PEEKSKILL. N.Y. NEW YORK �a �c» -•rip ! � ; 0 UP,E.`�— -�o..4 � �- � 'P E.. & L.S. NVS LIC. NO. 27846X-•X Y. SCALE 1' � � � � • + � •, �n � . ,