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HomeMy WebLinkAbout2907DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 62.15 -1 -26 BOX 24 02907 vilville OEM "I Ir 01 IN no 1 1 r ILI Is 1 . ] . 02907 DEPARTMENT OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 'APPL'iCATION TO -CONST'i .`-T- A- 7TER GTE.1iL : PCHD PERMIT # WELL LOCATION Street Address 72 4q A:�,Y !" Town/Village/City Tax Grid Number r � 4� WELL OWNER Npme ID W,4 -LR,4 Mailing Address Jdo 40 � 4MC 1111M 10 hfjl ld O RTrivate D Public USE OF WELL 0 - primary 2- secondary 16ESIDENTIAL ® BUSINESS O INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION U INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE d4a Sal REASON FOR DRILLING WREPLACE EXISTING SUPPLY 'O TEST/ OBSERVATION LIADDITIONAL SUPPLY O NEW SUPPLY NEW DWELLING : ® DEEPEN EXISTING WELL DETAILED REASON FOR DRILLING 5 a L �� L, /.� t WR Li GE 466W , ,22CL 401:r7 -1-Y CdZ AJZ4 4 f. aAJ � L O WELL TYPE DRILLED DRIVEN ®DUG ®GRAVEL O OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: t��Ll�tr�es�D iC°i(LA�L� Lot. No. WATER WAIL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: ✓ YES NO NAME OF PUBLIC WATER SUPPLY: f e' 5 y I_df*Q�- y � �°rtlJ- /S�i�T TOWNIVIL /CITY � /j��LJ /i¢tLE'i1 DISTAPCF TO PROVIRRTY FROM_NEkREST: WETTER MAIN: LOCATION SKETCHOURCES OF CONTAMINATION PROVIDED ON SEPARATE SHEET — (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 thirt }� (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 drills operations be contained on this property and in such a manner as not.toocontamin to surface or groundwater. 67-7-- ddeegrade.or oth wi Date of Issue: 3 a-� 19 ( Date of Expiration 31 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 ....................., 19....80 TOWN OF PUTNAM VALLEY N° 80 -5 375 PERMIT RECORD � ,4024T� is hereby made for .... `..'.....iir r.;°. i,._.:.:.- :: ..:..........................., ...._ ._........... .......... Permit Work to start.... .... AR-ONCE .................. REGULAR.... WELL :....:..:....................................................................... .........._.................... �...o.....d _ -; - .:,; >..,:.... of. Premises — Street or Road....... LAKEFRONT... RO..P. ... TM41 -f — 2 ................. .............................._ ............... ............................... • ---.. ................:.... BLOCK ........................... LOT ........................... FRONTAGE ............ : ............... ........... .... Depth .......................... Rear ........................ (other description) or number of square feet....; ................... "' ISIONNAME ... .. .... ... WWK ............... ........ ..... . .................. ........... ....... ... ........................ ....... ......:........ TEL...........: .:.. ... ..................... .. EVA... WOLFF ................................... .................... ........................... ADDRESS RD##3 -; .. F"UTNAM... VALLEY;.. ...N.,.Yo...................... USE CONST. ROOFING LAND Dimension of Building Family Wood Wood Shingle Paved Width Depth Stories Type Foundation Size& Use Each .................... ............................... Room with Window Area .............................. .................. ....... ... Sewerage Type ... ............................... .............. Size of Septic Tank ............ ...................... . Lineal Ft. Drainage. ............... ........ Size of Dry Wells .... ... .... ..... . Plumbing Description ............ . Well Description........................ ............................... AdditionalInformation ....... ............................. .. ......................................................................... ............................... This application must be accompanied by a copy of surveyor's map and *cotnpiete- piers, spacifi.ations . and all information required by the Zoning Ordinance and Sanitary Code of the Town of Putnam Valley when requested by inspector. Estimated Fee $.., ................................. Building Cost $ 1800. Total Livable Area ................. .............. .... $ ........ ........................... Sanitary Date" Zoning Board Approval . . $ .... ............................... Plumbing $............15.0.0.0...... Well __...----------------------------------------------------------------------------------------------- : f_ _t/al F F _ Rt - _QUA— _,m— yi.4,Z 7 %so %a ~--- LAKz�.� i -- _._.. 1 Fa 2 Family Steel.,.. Asb. Shingle Dirt Log Cabin Brick Tile Oiled Bungalow Concrete Metal Swamp Apartment Stone Brook Store FNDTNS. INTERIOR Lake F. Store & Apt. Stone Rooms Dams Store & Office Concrete Apt. Rooms Sw. Pools Office Blocks Apt, Ten. Courts Gas Station Brick Attic Open Garage Piers Attic Finished OTHER BLDGS. EXT. WALLS PORCHES Barns BASEMENT Wood X Front !Shacks Part Brick X Side Cottages Full Brick Van. X Rear Bungalows Cement Floor Log X Encl. 1 Electric Finished Shingle MISC. Phone Garage B. In. Comp. Plot Plan Furnace Field Stone Driveway Type Foundation Size& Use Each .................... ............................... Room with Window Area .............................. .................. ....... ... Sewerage Type ... ............................... .............. Size of Septic Tank ............ ...................... . Lineal Ft. Drainage. ............... ........ Size of Dry Wells .... ... .... ..... . Plumbing Description ............ . Well Description........................ ............................... AdditionalInformation ....... ............................. .. ......................................................................... ............................... This application must be accompanied by a copy of surveyor's map and *cotnpiete- piers, spacifi.ations . and all information required by the Zoning Ordinance and Sanitary Code of the Town of Putnam Valley when requested by inspector. Estimated Fee $.., ................................. Building Cost $ 1800. Total Livable Area ................. .............. .... $ ........ ........................... Sanitary Date" Zoning Board Approval . . $ .... ............................... Plumbing $............15.0.0.0...... Well __...----------------------------------------------------------------------------------------------- : f_ _t/al F F _ Rt - _QUA— _,m— yi.4,Z 7 %so %a ~--- LAKz�.� i -- _._.. 100 Edgars Lane Hastings on Hudson, NY 10706 November 21,1996 Mr. Robert Morris, P.E. Division of Environmental Health Services Putnam County Health Department 4 Geneva Road Brewster, NY 10509 Dear Mr. Morris: In connection with the well permit application you have for my wife's property (TM# 62.1- 15 -26), I am enclosing a check covering the $100.permit fee and a copy of a survey plat marked up to indicate the location of the proposed well and of septic systems on this and immediately adjacent properties. Figure 8 presented in the report I prepared for the Wildwood Knolls Improvement District and submitted to you, shows that septic systems on other nearby properties are all more than 100 ft from the proposed well location. I understand from Ms: Lenore Herbert the-Putnam.Valley.District Administrator, that, for properties not requiring a waiver of its normal separation requirements,, the. Department'has_„_.agreed to issue permits upon - receipt of the permit fee 'and either a.marked- up plat showing the location of the house, septic .system and proposed well, or an enlargement from the tax map (to a scale of 1" = 201) showing approximately the same information. From our _Of. SNp.tPmher ._ 3D _.. _and _ _Ur_. "tober. I:� ,; . _L >Sc_, __: I_ farther- understand that with submittal of completed waiver applications, the Department will be able to issue permits for additional properties, bringing the total to nine of the fourteen still dependent on District system. I have contacted the owners of the remaining five properties (Hoffman, Blanchard- Young, and Geraghty /Ruddy /Werthner on the lakefront, and Madan and Madow for whose properties the Department indicated on -site separations were inadequate for a waiver) and am working to have each of them select, for your review, a specific alternative involving either an off -site well or wastewater system improvements. I have contacted the other nine-owne.rs, requesting that they send to Ms. Herbert a check (payable to your Department) covering their permit fee together with a property survey plat, if available. As these are received, I will add septic . system and proposed well locations to the plat, or show this information and the.approximate house location on an enlarged:_section_.of..the tax map,.:-­ forward these documents to you together with;_waiver applications as needed: The Department's prompt action as these documents are received will let most of the homeowners get started on drilling needed individual wells soon, so that all wells, including those. for the five properties with special problems, can be in place before the owners wish to use their property in the spring. This will free the District from the severe problems it will face if it. must to try to operate the existing water system for yet another season. Since the well for my wife's property is the first of as many as fourteen for which I may need to expedite drilling over the next few months, I am anxious to start making arrangements with a driller. Hence I respectfully request immediate action to issue this permit. I trust that once we have thereby blazed the trail, additional permits can readily be issued as we collect and submit to you the permit fees and the requested further documents. If you have questions at any time, please call me at my work number, 212 - 539 -7018, or leave a message on my phone mail there, or on my answering machine at home, 914- 478 -1109, indicating when I can best get back to you. Thank you. Ver truly yours, c David Walrath DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 PROCEDURE FOR NEW WELL PERMIT APPLICATIONS BRUCE R. FOLEY, R.S. Acting Public Health Director 1. Well permit application is to be submitted along with fee, if required. 2. Locations of all sources of possible contamination within 200 feet of fhe. proposed well location are to be shown on a plan or tax map. 3. Contiguous neighbor notification is required. 4. Feasibility of well location is to be confirmed by a representative of this Department. 5. If the proposed well is within 15 feet of the property line the approved well location is to be staked by a licensed surveyor. If the proposed well location is within 100 feet of.any source of contamination the well location is to be staked by a Licensed Engineer, Registered Architect or Land Surveyor prior to drilling. 6. As built and well log to be submitted no later than 30 days after completion, by permittee. BRF /RM /jp August 1995 I 4 AL S • I o.46 Ac. B N 8 * $ all a _ 29 _ ei rr 8 �OpO a % a — jr 26 s 38 MAP' i A AN AL 51 ( • ti q� N N R - 35 404 c� tt•� a 6,�° • a 164 " O0 a • 1 9 a� ¢ /x 49 a a s.s 4 MAPLE ISLAM s ° Ixn s 1 yr ro 91 ♦ a +� 4p s r t, a( ♦ a n Is la 2 •OY�:p° Imp ,e e ® e �. 45 19 \ ��` 4r 2S i� iii i °, • It 6 k ly f g 8 �r s r 43 7 23 6 ? to -t --i --�- •\ ° •� a J' '�� `�1 • ' 111 •{ ! Ie2M � ( .� N /• r {tl el l{ 1 I • — • 20 20 6 r ul 6 10 F� . X10 o) f• 5 lao ''� �s� d AST it . ,ns s - Il,x 2 e NoT� I I B b a `P , c 2 y t 04W 4W • co N T 1 - o v 4 P-ib f......._. b?,.lj >I__. _r_.. _.a.�.. A=..a 1'1y ♦,l 1;. ;M'' ° _ - �. _ ?ra xw� IeJ Inn \141, 8 ��/�� 2 Poo P � � � s � b . ts_ f , ekom ••I ryi(0 ry �, lel.0 la R P/0 62.11 1.1 ,.. / @O 39 ` 1 ILL MILLV ROAD LR 1'0 OWNrl" ash 28 fi r,u fir. 4 40 c n = r No�� i 33 4 t 2.64 AE. CAL. 41 39 8 N21 OQO poll 26 G S � � � � P• � � �{, rC � it 2 x 24 ^ •�. 61.14- .,, �'� •,, t .t A° fi R{ 16 , w 4 13 es nae t� 9 44 4• 4 ,y e• //✓C V /i111%�j Me A! - 1 68 •` t ! IS,� 40 Al �(A/Btlg lerr71 ll1 -1 I.16 AC. CAI - ~• 'e`I,p .n 1,.. . oaf _ltr to Robert Norri s Well Permit Application.of Alice M. Walrath TM# 62.15 -1 -26 In reference to the subject application enclosed please find: - A tax map of Wildwood Knolls showing the 14 properties needing wells, and the nearby properties requiring neighbor notification (assuming on -site wells) - Bank check for the $100 permit fee - A copy of the site plan sent with neigbor notification letters for the Walrath property - A list of addressees for these neighbor notification letters - Receipted copies of these neighbor notification letters. Please note that the site plan is the one sent out with the neighbor notification letters, and should be substituted for the one submitted to you by Mr. Walrath in his letter of November 21, 1996. The new site plan shows a slightly revised well location. I believe this application is now complete. Please let me know immediately if there is anything further needed for you to approve it. Very truly yours, OU, k°' Lenore Herber District Administrator sa 3 L `$3 'I°®wn ®f Putnam V. February 26, 1997 , i William L. Meyer 416 Oxford Drive Nokomis, Florida 34275 Dear Mr. Meyer: Re: Review by the Putnam County" Department of Health of proposed well for the following property: Name.of Owner: Alice Walrath Street Address: 72 Lakefront Road, Wildwood Knolls Tax Map Number: 62.15 -1 -26 (Town of Putnam Valley) Please be advised that the owner of the above property has applied to the Putnam County Department of Health for a permit to construct a well at.the location shown on'the attached site plan. If, as a neighboring property owner, you have any questions, concerns or information which may influence the Department's review of this application, you may call Mr. Robert Morris of the Department at 914 - 278- 6130,.Extension 166. ;nv ,? tr. ? t�t�atL,y-q- - h notification, please complete the acknowledgement below on one copy of this letter, and return that copy to me right away, using the enclosed stamped envelope. Sincerely, Lenore A. Herbert District Administrator 914-526 -3293 In duplicate Received by: (Signature) l- Printed Name:164//" �- i''!le�1��' Date: a Property Tax Map No. 62.15 -1 -27 265 Oscawana Y.ake Road o Putnam Valley, New York 10579-9 (914) 526- 3280.`_...._.�..,..;�,,I Town of Putnam Valley February 26, 1997 i Kathleen Bihr 3 Wildwood Lane .Putnam Valley, NY 10579 Dear Ms. Bihr: Re: Review by the Putnam County Department of Health,of .proposed well for. the following property: .Name-of Owner: Alice Walrath Street Address: 72 Lakefront Road, Wildwood Knolls Tax Map Number: 62.15 71 -26, (Town of Putnam Valley) Please be advised.that the owner of the above-property has applied to the Putnam County Department of Health for a permit to construct a well at the location shown on the-attached site plan. If, as a neighboring,property owner, you have any questions, concerns or information which may influence the Department's review of this application, you may call Mr. Robert Morris of the Department at 914 - 278 -6130, Extension 166. ;._ To let us _document . fnr. -the .- De.partment ,that you have. received-: thi s- - . -'riot f icat on o-- _please -complete `the - -ackr do -gId igement-- below --ori' one copy of this letter, and return that copy to me right away, using the enclosed stamped envelope. Sincerely, Lenore A. Herbert District Administrator 914 - 526 -3293 In duplicate Property Tax Map'No. 62.15 -1 -28 265 Oscawana Lake Itoact • Putnam Valley, New York 10579.0;� „,,(914) 52G -3280„ , Town of Putnam Valley February 26, 1997 Mortimer Sperling 90 Gold Street New York, New York 10038 Dear Mr. Sperling: Re: Review by the Putnam County Department of Health of proposed well for the following property: Name-of Owner: Alice Walrath Street Address: 72 Lakefront Road, Wildwood Knolls Tax Map Number: 62.15 -1 -26 (Town of Putnam Valley) Please be advised that the owner of the above property has applied to the Putnam County Department of Health for a permit to construct a well at the location shown on the attached site plan. If, as a neighboring property owner, you have any questions, concerns or information which may influence the Department's review of this application, you may call Mr. Robert Morris of the Department at 914 - 278 -6130, Extension 166. To let us document for the Depar tm=n t_. that., y .u._ Ya %e:.xece- j rQd -. t,h.i s notification, please +complete the acknowledgement below on one .copy of this letter, and return that copy to me right away, using the enclosed stamped - envelope. In.duplica Received b Printed Na to y: (Signature) Wz S/� Nam Sincerely, Lenore A. Herbert District Administrator 914 - 526 -3293 : - �� 7. Property Tax Map No. 62.15 -1 -25 265 ®scawana Lake Itoad * PLIMIIM VVaalley, Ncw York 10579,�;®(914).526 -3280 ,,w i February 26, 1997 Kent Zook Z, High Street Putnam Valley, NY 10579 Dear Mr. Zook: Re: Review by the Putnam County Department of Health of proposed well for the following property: Name -of Owner: Alice Walrath Street Address: 72 Lakefront Road, Wildwood Knolls Tax Map Number: 62.15 -1 -26. (Town of Putnam Valley) Please be advised that the owner of the above property has applied to the Putnam County Department of Health for a permit to construct a well at the location shown on the attached site plan. If, as a neighboring property owner, you have any questions, concerns or information which may influence the Department's review of this application, you may call Mr. Robert Morris of the Department at 914 - 278 -6130, Extension 166. To let us document for the Department that you have received this notification, please complete the acknowledgement below on one copy -cf - this lettar; u:.d recur:. that campy to «e r grit away; usiiig the enclosed stamped envelope.. Sincerely, In duplicate Received by: Printed Name: Lenore A. Herbert District Administrator 914 - 526 -3293 Property Tax Map No. 62.15 -1 -17 & 18 (Signature) Date: 265 Oscawana Lake Road • Putnam Valley, New York 10579;.*, j914).52Cr3280, Applicant: Alice Walrath 72 Lakefront Road Putnam Valley, N.Y. 10579 Tax Map No. 62.15 -1 -26 Notification Letters Sent To: Kathleen Bihr 3 Wildwood Lane Putnam Valley, N.Y. 10579 Tax Map No. 62.15 -1 -28 William L. Meyer 416 Oxford Drive Nokomis. Florida 34275 Tax Map No. 62.15 -1 -27 Kent Zook 11 High Street Putnam Valley, N.Y. 10579 Tax Map No. 62.15 -1 -17 & 18 Mortimer Sperling ,Gold- StiL_�et . . New York, New York 10038 Tax Map. No. 62.15 -1 -25