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631- 589 -8100
62.15 -1 -26
BOX 24
02907
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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
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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
__...-----------------------------------------------------------------------------------------------
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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
__...-----------------------------------------------------------------------------------------------
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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
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. 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