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HomeMy WebLinkAbout2104DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36.57 -1 -8 BOX 18 ME . . I L V Nos ■ TL ir la I r JJFL 02104 �B DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 APPLICATI—M -TO CONSTRUCT A WATEIr- WELL'° "ii..`'' . PCHD PERMIT # W WELL LOCATION Street Address Town/Village/City Tax Grid Number 25 Kensington Road, Brewster, NY WELL OWNER Name Mailing Address OPrivate Peter Schira, 25 Kensington Road, Brewster, NY 0Public USE OF WELL 1 - primary 2 - secondary 0 RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP 0 ABANDONED O BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify 0 INDUSTRIAL 13 INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT _,!J7,gpm /# PEOPLE SERVED a /EST. OF DAILY USAGE /Sb gal O REPLACE EXISTING SUPPLY O TEST /OBSERVATION M ADDITIONAL SUPPLY M NEW SUPPLY :TEW b 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING Shares well with neic{hbor now. WELL TYPE ©DRILLED DRIVEN ODUG GRAVEL. 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name P . F . Beal & Sons, Inc. Address: 4 Putnam Ave . , Brewster IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES Q NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY -- .. - DiST-#NCE TO- PROP -ERTX F.�4�M- NEARES.T_J�IATER .MAIN:,..- - - - -._ .:_ -.__' __�_ _. _...,..�. :_ ._..--- .- ,--- -•. -.. .._._... _.:... _ 9- LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ®ON SEPARATE SHEET _ 6 20/96 (date) ( gnat Pe f'r'y L. Beal 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 s oundwater. Or Date of Issue: �C�c.,P :2 7� 19� Date of Expiration 19 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller N 936000 U STER ROAD six i do W . t :.y�e • z ft 1 _.. _.. 0-0. .... _ ...� 10' 1 � S o0 i 1 1 1 IV KOO ` a t� .20 so�9 . .. ow - .0.00, so o WESLEY IQ' _ t2xpa 1 1 1 1 100.00 4 1 1 1 i 1 i : 20i i i � i 1 1 1 ` 1 • $ �1 .9 Low JI! Q ill loan J'9 ale 7. JAI/ AD T year Of Cri %j CA _' I -;)rcne s-cr,clione ,� �� 26 _ �� ' > �OWn : aet2 �a h + ling Address .. Addition of crcGMS ption proposed null moer ;cri 'no bedrOOms house �- -1 n6er of ex! e Of G:. -d—icn - Footag -,,cosed Ac X A] Square e d e H 1J, 'O�ag flocr Squar- H 'jt7" Fc area A O� n % irc:-ea5e Ft2-, NIA1, cc'�j' -no zollowing -c -me In c o,,)c;ne form a., .ease subm' tV F PENS OAD, -,:q AnD 6), r PROP 6 tz- C S-'cc' -ing . 1110 cz CHE�cK for cc an- dra, ::__zicna� c' P-, an. --- C' ro c wed Tcnc cc;a lk= C h .0, Any 0 sue' nowt: ­cr� pro t— r c if CoDy Of s of in=,L- ,A* 'clie t G. I rc; pobert 4, IN - led AD_ nD -SUL 0 R= FE A,_)D' d CIL. area V. S no. Go c6_0 , plans (a'! • 'K for _�'ng T Sketch of ex's Sket ne" profess enal -c-on r plan. Won---' d f CC- Ij -�ose ny h of props em. orepared 3. Sketch 'Onal drawing System no 'uired. rofe i C.sal may be re N,on P ewage r,q�rements, A s for the oode Plan meeting preen` C,FF.,,CE USE ocnditiOr`2 19 S' Ccfr,ments and/Gr ------------- e, rl 41 ;Ira Etl_ 61� 44 .157 -[ITLE Approvp-d byV 67 t'-'; +I O vs A 40 I 'JI J1 ---- -- ----- QVO-1 Ik -, I/ ,j -.1 4 11 11 CN N, Nt UN u s, 13 I 'JI J1 ---- -- ----- QVO-1 Ik -, I/ ,j -.1 0 7: trt �34 IYIF JUNWAV its /Y 2 not EAi NP i LOW 01; now S: wl 41", 'h-, ,R,:"JrE,3 pr E30.x 716 "F` PRIUPE"ITY Pon.; M, ME Now YOW, 11, , i r 0 '-, A pis cvmouny W or mpg Y'V apcj !-,, —'e I I U1 R 443 rIPE 46 P.`rrBl made ti s ci' /qjp4l c +5 between lu.b_nT.,; it and' wi0fe, c..icin at 2.F? Wee t' bot'n.Strcet, Pcrou;-,r. of.:anhetten, City/, Count,? and S ate .of New Ycrk,' parties of the: first eart,.and,i''„Td1CK iCtii;PiiY and :•:OLLi'� IY,,rn is, , wife, residing at 215 ;:le son avenue, Borough and ' County of drerx, City and State' c1 i1ed,York, and sl iiti:; SL L Ji;; end r.k:, ?i., SUiI: V. N, n_s ,11 e, residing at 111 'lest 190tH Street, Eor'ouuh' and County 'of Bronx, Cit and State of IJew York, aartiea of the 'second part, i itLAa,.the panties 'of t he, "irst part owrAtorcmises at' , ?utn ql Lake in the Town cf ?att.xson, eutnar'i :lounty, llew known: as Lots 255throu,,h 259 and 26.0 t .rout,,,h 269, as ahnwn on `,..A "ap at' Putnam Leke,.Yutnem County, New :!ork,;.and .Fairfield County, Cor'neeticut "., and filed in the 'Putnam'County'Clerk's office on the 20th Bay of ,•.p'ril 1931, File No, 1a9 ;and Wnr4iL4S, said'oertica ci'„ the first part.a.re the owners of ' record'cf aaid;gremises except a portion of acid premises known as LOts':265 2(9';As shcwr- on said aap,.which they convey�d to the part >s.o.,'the :. second' part cy deed ^ dated .,Janue ^y 9, 1954 and re- cor,ded`in..the,said Clerk's., office in Bcck.LE40 of Deeds 'et cage 242 cn ''Sanwa =y; a' ',, 1954... aria ' `r +hl iiLA9; IhL i is a''wall situate on a portion of the Pots above described, known. as Lots 260 -2641., which well has heretofore, furnished water to ;the said.:urcmises, which have been considered ' as three separate:dwellings,,that is,one:parcel including Lots,, i,;,255- .259,.' and .another. parcel including ,i ots, 260 -261J, and the latter pa:c:el ir.cluding.Lots ,.265 -269,, as'shown on said man,'th "er,e.b:ing„ Separate pipe lines from,the well un,said.'pramises extending ,to. d the dwe'llin'gs.'on the'resnec'tive' parcels through which water. has 'beer..and ie presently be in supp ied to the three separate'oareels fron said well, IT6'•i TrIS.!NDnt!TII.ti :,iTa_'SSETH, ,that,'tae,._o'arties herto'.'in;aonsideration . of the sum cf Cne Dollar lawful money of the United States, each.to the other, in hand,oaid, receipt whereof is hereby acknbwled fed, he - -eb,; covenant and agree ea .follows: l,''That.the three separate oarcels above described shall coht,inue .te, receive'vater from.t'.0 well' above' described ds' hereto ifare t >reti;;h tre existing pine lines running from the.wellto ,the resoectiv.e dwellings.cr, the three s'enarate parcels, 2 `That the respe ctive owner.or owners of said three. 'separate parcels.will be'consid,.red to jointly own the pump and numping'equlpm6nt furnishin'4: water from said well to said•,three separate.par�ela,,end.t!'ie owner o.r' owners. of each of said - three'` separate;�r.cela, shall. 'gay their.,•rr"� rota shore cf thirty - three and 'one,third•per eentum per annum of the cost of the cnerat?,on' and ,mainten&nce,:includin electricity of the oumgine ec`t,flmcit. c ece fc5r tha ecconuliehit,g.rof the• sup l}.in , of water to ne dtiell r s. cn said'triree'iatcEls, 't`he ov:ners of each cP,s id"`ti�ree` n'arcels however to maintain -the ind ".vidual pipe line'runriin& from the well to the dwelling.cn each oi'.said parcels. 3 The partiee,hereto covenant and agree to co- operate "wit1 cne.arotner snd the, owner or owners 'of the three senaratc parcels to the end Chet: each of said aarceis sill be supplied with water from said well..for all reasonable ourooses, and in a reasonable manner. 'That the owner or, owners'. of each of said sei to t. pr.s•ods ahali have sc,cess tc se-id W611'and pumping equipment for the aurpcse ci' i ?:sp'ebticn and the maian of necessary repairs 'to I ,,