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HomeMy WebLinkAbout1971DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36.31 -1 -46 BOX 18 01971 L_DEPARTMENT OF HEALTH Division of Environmental Health S 1 ervices TWO COU Y CENTER - CARMEL, N.Y. 10512 (914) 225 -3641. APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT WELL LOCATION Street ddr ss Town ge City ' Tax Grid Number WELL OWNER. e Mailing o �,.✓ Address Q / y, /M�•�L.� (/q .f► -s+'a� rivate O Public USE OF WELL 1 — primary 2- secondary '":IRESIDENTIAL OPUBLIC SUPPLY 0AIR /COND /HEAT PUMP 0 BUSINESS O FARM ❑ TEST /OBSERVATION 0 INDUSTRIAL O INSTITUTIONAL O STAND -BY 0ABANDONED O OTHER (specify Q AMOUNT OF USE YIELD SOUGHT_ gpm /# PEOPLE °SERVED /EST. OF DAILY USAG 7 gal REASON FOR DRILLING C1 NEW SUPPLY jt.0PLACE EXI TING SUPP Y O PROVIDE ADDITIONAL SUPPLY O DEEPEN BXISTING WELL O TEST /OBSERVATION DETAILED REASON FOR DRILLING © �' on dQ ANe e d elirS G WELL TYPEjtILLED DDRIVEN DUG aGRAVEL OTHER IS WELL SITE SUBJECT TO.FLOODING? YES �� NO wi a IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: /(/4V Lot No. WATER WELL CONTRACTOR: Name Address • dJ* iB Alt IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY _DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED OQN REAR OF THIS APPLICATION ❑ ON SEPA E SHEET d (date) (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 s.hall: 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 De artment. r Date of Issue : iv o 19 —�� �- Date of Expiration: 19 Permit Issuing ci _� Permit is Non - Transferrabl White Copy: H.D. File e Yellow copy: Building Inspector 2/87 P mk Copy: Owner Orange copy: Well Driller 4 Putnam Avenue P. F. B E A L& SONS, I n C. BREWSTER, N. Y. 10509 Tel. (914) 219-2460-2461 ARTESIAN WELLS, PUMPS - COMPLETE INSTALLATION AND REPAIR SERVICES THIS CONTRACT, made this ... 51 day of J�Ji' .............. , 19....$$ between P.' F BEAL & SONS, INC., Brewster, N. Y., and ..:j�m@s 'Qermaina. 105 - Haviland Dr. rPattorsonpKY. X2563 T e ......................................... ................... • ........................................ ..........._.......--- ......... Business..................... - .......... _.......................................................................... Home Tel.. 2.79-• 7. 535 ............................ WITNESSETH, IT IS HEREBY MUTUALLY. AGREED, as follows: That the contractor agrees to drill a well six inches in diameter, upon the property of the,,owner at a point designated by the owner, and to such depth as may be fixed by the owner or representative of the owner. f.� Property address `of owner .._.........._........... SAME ............... .............. ............. .......... ............................................................................. _................. )y _ ........................_....--................-...._....--.............--...-.. .... ...... ......_.._.-.........._........................................................ ..... ............. the contractor agrees to furnish and place in position in the well in a thoroughly workmanlike manner, a casing con- sisting of a standard pipe six inches in diameter inside measurement, extending from the surface at .least 10 feet into the solid rock, and. to furnish all fuel, labor and cartage for drilling said well. That the rate for drilling will be ....... ()o ....... per foot. _ sgetr��as��aa That 6Wi6te` for drilling existing weli_'deeper-will be :..... _ ... - .:. ............. :._.,.......... perjogt: That the rate for moving drilling machine into property, setting up over well, removing pipe, etc., until drilling com mences will be ...- _�:~.s :: was That the rate for six inch casing per foot will be ......$120. .............. That the cost: of.. six inch drive shoe will be - - -fir ===2t_Jt= That payment of the.total depth at the above rate is due after the completion of the contract. That the well shall be drilled to the minimum depth of ..- ....75 ................. feet. That the contractor does not guarantee to obtain any specific flow of water from the well and in the event that no water is obtained in the well, contractor will be paid in full for all drilling footage, casing installed or set up charges as stated in this contract. That if drilling be discontinued by the direction of the owner or representative at a less depth than the minimum depth, payment shall be made for the aforesaid minimum depth, or if drilling be prevented or prohibited by the direction of.the owner, or representative, payment shall be made for said minimum depth, which said payments shall immediately become due and �.- payble upon such discontinuance or such prevention or prohibition. ' That the contractor will carry on the work without unnecessary delay, and will have a competent man in charge of the work at all times, and permit no unnecessary damages to the premises of the owner. Removal of drilling cuttings will not be the responsibility of the contractor. Repair to ground damaged by contractor's equipment in process of getting to and from well 'drilling location shall not be responsibility of contractor. _ That the owner shall be responsible for complying with local laws, zoning ordinances and health regulations in selecting site f ^r the well. That after this contract is signed the location of the well must not be changed. That the contractor is completely insured b compensation and public liability insurance. That the well shall be .started on or about . °3.._..... weeks , su�bjec�to change du o delays beyond the ... L contractor's control. 8�'ter 1'F? iC121"11 Of �$ _ COFI ra 8 That the owner shall make a deposit payment of $250.00 to apply on this contract. On unpaid balances of W days or over we will compute a finance charge of %. per month hich is 18% annual per - centage rate. P. F. BEA & C. Owner:..............................................._..............._....... ............................... By Witness: .................................................................................................... Date: ....... I ...................................................... ... ....:.... L. S. . *Quotation* Artesian Wells Automatic pumping equipment P. _ =F. BEAL.�& SONS. INC. established 1891 �._._.._ James Germaine 105 Haviland Drive Patterson, NY 12563 Att: 4 Putnam Avenue Brewster, New York 10509 914- 279 -2460 Now Drilling Well No. 9902 Description June 5, 1988 Page 1 of 2 pages I wish to submit our price and recommendations for the following pumping equipment to be installed at your property. This quotation is based upon an estimated well depth of 170' and 60' of casing. The actual price will vary if the well depth and casing are more or less than the estimated amounts. In the well we will furnish and install a GOULD SUBMERSIBLE PUMP, fitted with a 112 horse power, 230 volt, 3 wire, single phase, lightning protected motor. This pump unit is guaranteed for a period of 5 years. - - -• .Th i.s , submers -i ble..pump. -w.i 1 1 beset - i n the .we ,I 1. at a depth of 150 feet using 1 inch, 200 p.s.i. polyethylene pipe. This pipe will be connected to the side of the well casing using a BRONZE PITLESS ADAPTER as approved by the State Department of Health. From the pump motor we will furnish and strap to the pipe in the well, at 20 foot intervals, the necessary number 14/3 double insulated, rubber milprene WATERPROOF SUBMERSIBLE WIRE. Between the well and the house we will excavate a trench approx- imately 4 feet in depth, where possible, in which we will furnish and install the necessary 1 inch, 200 pound high density pressure polyethylene pipe to be used as the water line. We will also in- stall the necessary 1 inch, 125 pound pressure polyethylene pipe through which we will sleeve the necessary number 14%3 SUBMERSIBLE WIRE. We will rough grade backfill over the line. We will use the existing tank. On the tank we will furnish and install all the necessary valves and fittings to complete this installation. James Germaine P. F. BEAL & SONS, INC. 4 Putnam Avenue Brewster, New York 10509 Description We will take a bacteria analysis. July 5, 1988 Page 2 of 2 pages The preceding will be installed and guaranteed for a period of one year against defects in materials and workmanship for the sum of . . . . . . . . . . . . . . . . . . . . . . . . . $1591.00 170 feet of drilling @ $8.00 per foot . . . . . . 1360.00 60 feet of 6" casing @ $9.50 per foot. . . . . . 570.00 If you wish us to proceed with this installation, kindly sign and return one copy of this quotation. If you have any questions, please let us hear from you. Terms: Accepted Date $3521.00 Thank you for the opportunity of submitting this q tation. P. F. BFAQ & 2O Z, INC. Perry/ L . Beal Artesian wells Water Systems Water tanks * * * P. F. BEAL & SONS, INC. est 1891 P.O. Box B -4 Putnam Avenue Brewster, New York 10509 Tel. (914) 279 -2460 James Germaine r----� 105 Haviland Drive Patterson,-N.Y. 12563 Dear.Mr. Germaine: July 5, 1988 -2- 2 S " .5 -- Submersible pumps Suction pumps Jet pumps With regard to our recent conversation, I am enclosing contracts to drill a well on your property. The 6 inch casing mentioned in the contract runs from the surface at least 10 feet into the solid rock where it is grouted in accor- dance with the regulations of the New York State Department of Health in Putnam County. This casing is new, heavy duty, seam- less steel pipe weighing approximately 19 pounds per foot. _ ........ .- E. t.he, - contr-act- 'meets..wi-th ,your - ...approval ; pl ease- s ign• and ­ retcirn - -- __ -. - -.- one copy so that we can place your name on our drilling schedule. If you have any questions, please let us hear frolp you. /pr Enc. �S, Very truly yourJ�, P. V. EJEALA WNS, INC. . Beal