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62.18-1-34
BOX 25
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� #
03025
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF ' HEALTH
1 Geneva Road, Brewster, New York 10509
April 25, 2006
Concettina Ruggiero
5 Azalea Drive
Putnam Valley, New York 10579
Re:
Dear Ms. Ruggiero:
ROBERT J. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
Addition Approval — Ruggiero, A- 119 -06
No Increase in Number of Bedrooms
5 Azalea Drive
(T) Putnam Valley, TM# 62.18 -1 -34
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 the Department dated April 25, 2006. The addition is approved with the following
conditions:
1. The total number of bedrooms must remain at two without prior approval by this
Department.
2. The area of the existing sewage disposal system and its expansion area must be
maintained.
:--- L:All..plurr bih.g.:fixtures: must. be updated.with watex saving _devices;:(i.e:_riew low flusb.
toilets, restrictors for shower heads and faucets etc.).
4. The approval is for the proposed changes only. This approval does not validate any
construction shown as existing that has not obtained proper approvals.
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.
Sincerely,
e 2 �. (//
Joseph S. Paravati, Jr.
Assistant Public Health Engineer
JSP:cj
cc: . Building Inspector, (T) Putnam Valley
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845) 225 -5186 Fax (845) 225 -5418
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention[Preschool (845) 278-6014 Fax(845)278 -6648
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT ' OF HEALTH
ROBERTJ.BONDI
nty Executive
F
1 Geneva Road, Brewster, New York 10509
ADDITION APPLICATION RESIDENTIAL ONLY
ST)tEET�1�7aa� Acs TO�'le1 i h c MAP#
N n r C-0 PHONE °I C/- C? I - S 7jc - PCHID#
MAILING
ADDRESS
DESCRIPTION OF
ADDITION S VIWCA
.)A-- -A -e W tx��
NUMBER OF E3GSTING BEIDROOMS_ PROPOSED # OF BEDROOMS C;L-.
(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 and the following to Putnam County Health Dept., 1 Geneva Rd,
Brewster,NY 10509,'Phone: (845) 278 - 61.30: -
1. Certified check or money order for $100.00.
2. Sketches of existing floor plan (drawn to scale, al➢ living area including basement)
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 locations 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 Certificate of Occupancy from Town or Certification from Building
Dept. with legal bedroom count of dwelling.
OFFICE USE
COMMENTS
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085
Early Interventiow?reschool (845) 278 -6014 Fax (845) 278 -6648
SHERLITA AMLER, MD, MS, FAAP
Commissioner of He° ik- = --
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Town Legal Bedroom Count
ROBERT J. BONDi
Re: / _ 1/ �- f�iAO(Owner's Name)
Tax Map #: �,� /�',� 1 C3 Z/
Address: � e L. 6
Town:
P. v
Year Built: t 1 g
According to records maintained by the Town, the above noted dwelling, to
is t/ in compliance with Town Code.
is not in compliance with Town Code.
The Legal Bedroom Count is:
This information has been obtained from:
Certificate of Occupancy:
Other: - SSA ,S �lL.
Building Inspector Dat
Environmental Health (845) 278 -6130 Fax (845) 278 -7921
Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678
Nursing Home Care Fax (845) 278 -6085
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
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OMERI S NAME /'`� ` v// /" % /77 CY. U '`7 PHONE
SITE I=TIORi
MAIIMiG ADDMS
PM1SON DUERVIEM PM Complaint
Dame & Relationship (i.e, owner,tenant, etc.)
DATE G// / " Z ; % G% TYPE FACILITY 0� v s�
PROPOSED III TJ LJM :24 ' J-:? PHONE
Proposal (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original sewage disposal system.
Different location may require submittal of proposal from licensed professional engineer or
registered architect.
�c
Proposal approved
Inspector's Signature & Title
Proposal Disapproved
ro»osal approved with the following conditions:
1. Procurement of any Town permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name.
b. Site Street Name, Town and Tax Map number.
ce Location of installed canponents tied to two fixed points
d. System description (e.g., 1250 gal. concrete septic tank,
drywells surrounded by one foot + gravel).
e. Installer's name and number.
Date
(eog.,house corners).
three precast 61 diamo x 61 deep
3. System repair to be performed in accordance with the above proposal and conditions.
I, as owner, or reported agent of owner agree to the above conditions.
SIGI UMM /'/,, /41, TITLE
DP%ES: ftte (PLED); IeUow (Tam HI); Pink (kliaant)
DATE /
PETER C. ALEXANDERSON
County Executive
February 15, 1989
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
Elana Weidman
200 W. 15th Street
New York, New York 10011
Re: Proposed Well Relocation
Weidman - Columbus Avenue
(T) Putnam Valley
Tax Map 52 -2 -25
Dear Mr. Weidman:
O I
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Please be advised that this letter shall serve to modify Putnam County Department
of Health Permit #W 160 -88 to approve the revised well location in the area of
the concrete block garage. It is noted that the proposed well serves an existing
one story frame dwelling previously served water from a shared well located on an
adjacent property, access to which has been denied by the present property owner.
`.I. ..i .- rec -ogtiizetd - that-- rhe-,plroposed well location does not meet -today'-s-standards
for separation distance between a well and subsurface sewage disposal system of
100 feet: the proposed location, which has been measured in the field by a
representative of this Department is 57, 60 and 70 feet from adjacent sewage
disposal systems. However, in the opinion of the writer, this proposal
constitutes an improvement to the presently provided 45 foot separation distance
from the well presently serving this property and the sewage disposal system on
this property.
In addition, based upon the above and since the dwelling on this property is pre-
existing, it is the opinion of the writer and the County Attorney that the 100
foot separation distance requirement is not applicable.
As a conditon of this approval, the following is required:
1. That a well completion report must be provided to the Deprtment.
2. That an as -built plan be provided to the Department showing the new well
location and the location of the adjacent sewage disposal areas.
3. That the results of bacteriological and nitrate analyses of samples of water
collected from this well be provided to the Department.
4. That this well be double cased 10 feet into rock.
-2-
5. That you consider the installation of permanent and continuous disinfection
equipment to treat the water from this well. Ultra violet disinfection equipment
is recommended.,
6. That you consider sampling the water from the well on at least a quarterly
basis for bacteriological and, nitrate analyses.
You are hereby advised that this well is not to be placed in service without
final approval from the Department, which approval will not be granted until
conditions 1 through 6 above, have been satisfied.
Ff you ha a any questions, contact the writer at Ext. 304.
P
V y tru r ,
dhn Kare 1, Jr., P.E.
irector,
Environmental Health Services
JK:pt
cc:Marvin Odell, Building Inspector
JK
File
EC
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.. .. �..
.- ..- •- I...h -.. � r: •~• .. .r r -. .. - . -. ... r. .. - ....w r v 4. ._. .1., h .... .... ... � -
-2-
5. That you consider the installation of permanent and continuous disinfection
equipment to treat the water from this well. Ultra violet disinfection equipment
is recommended.,
6. That you consider sampling the water from the well on at least a quarterly
basis for bacteriological and, nitrate analyses.
You are hereby advised that this well is not to be placed in service without
final approval from the Department, which approval will not be granted until
conditions 1 through 6 above, have been satisfied.
Ff you ha a any questions, contact the writer at Ext. 304.
P
V y tru r ,
dhn Kare 1, Jr., P.E.
irector,
Environmental Health Services
JK:pt
cc:Marvin Odell, Building Inspector
JK
File
EC
PETER C. ALEXANDERSON
County Executive
February 15, 1989
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) .225-0310
Elana Weidman
200 W. 15th Street
New York, New York 10011
Re: Proposed Well Relocation
Weidman - Columbus Avenue
(T) Putnam Valley
Tax Map 52 -2 -25
Dear Mr. Weidman:
I
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Please be advised that this letter shall serve to modify Putnam County Department
of Health Permit #W 160 -88 to approve the revised well location in the area of
the concrete block garage. It is noted that the proposed well serves an existing
one story frame dwelling previously served water from a shared well located on an
adjacent property, access to which has been denied by the present property owner.
—It-is recognized -that -the -proposed-well-location' °dues - not °meet tdday'lls "standards-"
for separation distance between a well and subsurface sewage disposal system of
100 feet: the proposed location, which has been measured in the field by a
representative of this Department is 57, 60 and 70 feet from adjacent sewage
disposal systems. However, in the opinion of the writer, this proposal
constitutes an improvement to the presently provided 45 foot separation distance
from the well presently serving this property and the sewage disposal system on
this property.
In addition, based upon the above and since the dwelling on this property is pre-
existing, it is the opinion of the writer and the County Attorney that the 100
foot separation distance requirement is not applicable.
As a conditon of this approval, the following is required:
1. That a well completion report must be provided to the Deprtment.
2. That an as -built plan be provided to the Department showing the new well
location and the location of the adjacent sewage disposal areas.
3. That the results of bacteriological and nitrate analyses of samples of water
collected from this well be provided to the Department.
4. That this well be double cased 10 feet into rock.
1.
-2-
5. That you consider the installation of permanent and continuous disinfection
equipment to treat the water from this well. Ultra violet disinfection equipment
is recommended.
6. That you consider sampling the water from the well on at least a quarterly
basis for bacteriological and nitrate analyses.
You are hereby advised that this well is not to be placed in service without
final approval from the Department, which approval will not be granted until
conditions 1 through 6 above, have been satisfied.
of you have any questions, contact the writer at Ext. 304.
9
dhn Kare'll, Jr., P.E.
irector,
Environmental Health Services
JK:pt
cc:Marvin Odell, Building Inspector
JK
File
EC
t PUTNAM COUNTY_ HEALTH DEPART — .. b .. ...< .. .. . .. .. .. ..
DIVISION OF ENVIRONH ENT AL HEALTH SERVICES
John M. Simmons, M.D.
Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet l of
INSPECTION
NAME �1 QMN' _ Orig. Routine
_ Orig. Canplain
ADDRESS COL A r Orig. Request
No. Street Town I1 No. _ „ Canpliance
MAILING ADDRESS
P.O. Box Post Office Zip Code
TELEPHONE
Owi®rll
« . . I a Oil
Name and Title
DATE `�% u? `I TYPE FACILITY
TIME ARRIVED / / 6 TIME LEFT
Canplaint Canp
_ Final
_ Group Illness
Construction
Reinspection
Field, Sampling Only
Field Conference
Other
Explain
psi �l, r err
TELEPHONE:
PERSON IN CHARGE OR INTERVIEWED:
I acknowledge this Field Activity Report. SIGNATURE:
6/86 TITLE:
FINDINGS: /
— L.
j ( U v L
d v 4- ,rrt -y�j
psi �l, r err
TELEPHONE:
PERSON IN CHARGE OR INTERVIEWED:
I acknowledge this Field Activity Report. SIGNATURE:
6/86 TITLE:
S )D
-------------
- --- ------
�.MARVIN O'DELL:,.
Inspector
TOWN OF PUTNAM VALLEY
BUILDING, ZONING, AND SANITARY DEPARTMENT
January 30, 1989
Department of Health
110 Old Route Six Center
Carmel, N.Y. 10512
TOWN HALL
PUTNAM VALLEY,
(914) 526 2377
Re: Proposed Well - TM #52 -2 -25
Elana Weidman - Columbus Ave.
Gentlemen:
An inspection of the above noted site on January 29,
1989, has been conducted in response to your letter.
of January 17, 1989 to owner regarding the location
of a proposed new water well.
Evidence was observed of Septic Tank locations (metal
covers% exposed) at subject property, one of which
appears within fifty (50) feet of an existing well on
adjacent property.
- Evidence al "so ' "exist`s of "sub -s utfade"dspos.alT "systems
across roadway, known 'as Cedar Avenue.
Due to location of these SSDS areas, a location for a
water well meeting the minimum one hundred (100) foot
separation requirement could not be found.
It should be further noted,due to lot size (approx. k
acre), there appears insufficient space available for
expansion of existing SSDS, should above be provided
with a year round water supply.
It is suggested that a through study seeking a solution
towards preventing furture problems and better assuring
good water quality on this.propetty be conducted by a
professional in this field.
V6ry truly yours,
f
MA VIN 0 D
JX
Building Inspector
MO'D:es
cc: P.F. Beals & Sons, Inc.
PETER C. ALEXANDERSON
County Executive
Elana Weidman
200 W. 15th St.
Apt. 10E
New York, NY 10011
Dear Ms. Weidman:
/,Id
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
January 17, 1989
ENID L. CARRUTH, M.P.H.
Public Health Director
JOHN KARELL Jr., P.E.
Director
Re: Revised Proposed Well - Weidman
Cedar Are.
(T) Putnam Valley
TM #52 -2 -25
Permit #W- 160 -88
It has come to the attention of this Department through P.F. Beal & Sons., Inc.
that the approved proposed well location is not possible due to the inability for
a well drilling rig to access the area.
There;for.e,.befor,e an approval for a revised well location can be made by this
' Depar`tment;`a written approval from Putnam Valley s Ruff ing Inspector, Marvin
O'Dell must be received by this.Department.
If you have any questions, please contact this writer at Ext. 317.
LCW /kv
cc: P.F. Beal & Sons., Inc.
Marvin O'Dell
Very truly yours,
Lawrence C. Werper
Asst. Public Health Engineer
DEPARTMENT OF HEALTH
% 6
lal)l Division of Environmental Health Services
TWO NTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
APPLICATION 'T'O' CONSTRUCT
PCHD PERMIT
WELL LOCATION
Street-Address Town -
utDAL Igo
Tax Grid Number
us .6 2 -2 - 26-
WELL OWNER
Name
F-i..AA,14 Wrizj
Mailing Address .
;or o t, 1�2 i APT lo r . E-iu 4&gr
rivate
O Public
USE OF WELL
0- primary
2 - secondary
91RESIDENTIAL
O BUSINESS
0 INDUSTRIAL
O PUBLIC SUPPLY O AIR /COND /HEAT PUMP
O FARM 0 TEST /OBSERVATION
O INSTITUTIONAL 0 STAND -BY
0 ABANDONED
0 OTHER (specify
AMOUNT OF USE
YIELD SOUGHT
gpm /# PEOPLE SERVED .¢ /EST. OF DAILY USAGE t96 gal
REASON FOR
DRILLING
ONEW SUPPLY O PROVIDE ADDITIONAL SUPPLY
OtREPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL
O TEST/ OBSERVATION
DETAILED
REASON FOR
DRILLING
— o i A4 P gee"
r
S i2 p, p WF, t L
i "'. t JS
, c'5.• ±: _M o l klLl. Flen w7 e. ;Ct5Ti yj5c LE/.1 cm,,414 PI %
WELL TYPE
®DRILLED
DRIVEN
®DUG
-®GRAVEL
®
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 F, jJg_RLd Sd/iJS' , //C%G . Address: .4 Fij7.vA�gA)jr BzpkycsJrk,
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES V NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE TO �'ROF'ERT� FROM`NEAREST �JATER MAIiV: %t%�� �� µ��A
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
ON REAR OF THIS APPLICATION A
"tt9att
,
(date) (sig to e)
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 DD d .. 19 partmen
f I Ol ' ��7
Date o Issue: ue : ' ____�
Date of Expiration• d y f 19 ermit ssuin fficia
Permit is Non - Transferrable White copy: H. D. File
Yell Buildin In for
2/87
ow coPY• g SPA
Pink Copy: Owner
Orange copy: Well Driller
CIVIL SANITARY
JACK GOLDSTEIN, P.E.
.Consulting Engineer
101 STONEWALL COURT
YORKTOWN HEIGHTS, NEW YORK 10598
(914) 245 -1773
October 17, 1988
Mr. John Karell, Jr., Director
Environmental Health Services
Putnam County Department of Health
110 Old Route Six Center
Carmel, New York 10512
Re: application To Construct A Well For lElana Weidman
Property Located At Cedar Avenue (aka. Columbus Avenue)
Town Of Putnam Valley, New York
Tax Map Designation 52 -2 -25
Dear John:
My Firm has been retained by Mrs. Weidman, to prepare an
Application To Construct A Well, for the subject Property. I
visited the Site, and ascertained the locations of the existing
underground utilities as best I could, as I could not excavate
the lands of the adjoining properties to find wells or septic
systems having no visible surface signs. I spoke to neighbors
and the Owner, to obtain the probable locations of same.
~` The use of the shared well on Lot 23 has been discontinued.
Said well is located in the area shown on the Plan. The area is
located approximately 451, directly downstream of. existing
Leaching Pit °A °. The proposed well is to be located 1001+ from
existing Leaching Pit °B°, and is approximately level with same.
There are no existing septic systems west (upstream) of the
proposed well. There are two existing septic systems located on
the east side of Cedar Avenue, but they are located below the
proposed well. Additionally, there is a gutter in the Road which
will divert any septic overflow from these septic systems, in a
northerly direction, away from the proposed well.
This proposal, though not conforming to the current Health
Department Regulations, is a significant improvement over the
existing conditions. If you have any questions concerning this
proposal, please advise. Thank you for your assistance in this
matter.
Very truly
Jack Goldst in, P.E.
cc: Mrs. Weidman \
P. F. BEAL & SONS, INC.
P-0.:-BOX B-4 PUTNAM AVENUE
ARTESIAN WELLS.
-
WATER SYSTEMS BREWSTER, NEW YORK 10509
MOTORS - TANKS - BELTS - ETC. Established 1891 -- Over 9000 Wells Completed.
(914) 279-2460 - 2461
COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERVICE
of
A cc 0
P �,
0
I... - ., - - - .. - - - - -.- -. - : .. - . - - .... .1 -
JET-PUMPS —..'-.-.--'^-
SUBMERSIBLE PUMPS
SUCTION PUMPS
CELLAR DRAINERS
1111711�•
DAVID 0. 'BRUEN
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
Elana Weidman
157 E. 72nd Street
Hew York, New York
Dear Mr. and Mrs. Weidman
December 22, 1986
JOHN SIMMONS. M.D.
Deputy Commissioner
RE: Proposed Well
Construction
Columbus Avenue
(T) Putnam Malley
Application * 75 -86
Review of an application to construct a well for potable
eater supply purposes, to serve the above captioned property
has been completed.
Review indicates as follows:
1. The .proposed well is located approximately 80 feet from
the existing sewage disposal system on your lot, and an
adjacent lot.
- - - Reeognviz-ing.- t4..above, and that la minimum. separation distance
.of 100 feet is required between a sewage disposal system and
a well; your application for a permit to construct a well on
this property is hereby DENIED.
V r tru y yours,
kW
ohn Ka ell, Jr., P. E.
Director,
Environmental Health
Services
JK >pt
cc:JK
File
Mr. Odell ( T ) Bldg. Insp. P. V.
TWO. COUNTY CENTER - CARMEL, N.Y. .10512 (914) 225 -3641
3
DEPARTMENT OF HEALTH
Division of Environmental Health Services
/ TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
AP114TC4TION TO CONSTRUCT A WATER .WELL
PCHD PERMIT #
WELL LOCATION
S reet Addre TOW/Village/City Tax-Grid Number
0 M bus 1tv e- Pv-rN 4m valfe,,
WELL OWNER
.}_ lame l Address
�C -.�nQ- �' tCl J 7
Private
-2 13 ' . �, l� . D "'Public
USE OF WELL
1 - primary
2 - secondary
>
L RESIDENTIAL O PUBLIC SUPPLY
O BUSINESS 0 FARM
13 INDUSTRIAL C]INSTITUTIONAL
O AIR /COND /HEA PUMP 0 ABANDONED
0 TEST /OBSERVATION D OTHER (specify
O STAND -BY O
AMOUNT OF USE
Y ELD SOUGHT gpm /# PEOPLE
SERVED /EST. OF DAILY USAGE J" gal
REASON FOR
DRILLING
EYNEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY OTEST /OBSERVATION
❑REPLACE EXISTING SUPPLY ❑DEEPEN EXISTING WELL
DETAILED
REASON FOR
DRILLING
WELL TYPE
MDRILLED ®DRIVEN
QDUG OGRAVEL 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 �° C ` Address:
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES _ NO
NAME OF PUBLIC WATER SUPPLY: � TOWN /VIL /CITY
DISTANCE•TO PROPERTY-FROM NEAREST WATER MAIN: '-, JV
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED /
ON REAR OF THIS APPLICATIONON EPA TE S T
(date) signature)
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water we_l.l -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. .
Date of Issue: 19
Date of Expiration: 19
Permit is Non - Transferrable
Permit Issuing Official
<Cronick KeR Ltdo TALENTAGENCY
iy
�Y�2'0 Fifth Avenue NewYork City 10001 212/684-5223
December 15, 1986
Department of Health
Division of Environmental Health Service
2 County- Center
Carmel, NY 10512
ATTN: Ms. A. Bittner
Dear Ms. Bittner,
As per your request, enclosed please find a pictorial description
of the location of the houses, cesspools and wells in question.
This is in conjunction with my request for a new well.
Thank you,,
Elana Barry eidman
EBW/df
S'
rLW
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
John M. Simmons, M.D. l
Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of /
INSPECTION
NAME Orig. Routine
_ Orig.'Complain
ADDRESS ,�L!/J i Orig. Request
No. Street Municipa ity (T)(V)(C) Compliance
_ Complaint Comp
MAILING ADDRESS Final
P.O. Box Post Office Zip Code Group Illness
_ Construction
TELEPHONE
_ Reinspection
PERSON IN CHARGE Field, Sampling Only
OR INTERVIEWED Field Conference
Name and Title
i(
DATE TYPE FACILITY //� Other L
TIME ARRIVED TIME LEFT Explain
INSPECTOR:
Signature and Title
PERSON IN CHARGE OR INTERVIEWED:
I acknowledge receipt of a copy of this SIGNATURE:
Field Activity Report ..................
TITLE:
TELEPHONE:
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
John M. Simmons, M.D. f
Deputy Commissioner of Health - FIELD ACTIVITY REPORT - Sheet of
INSPECTION
NAME Orig. Routine
Orig. Complain
ADDRESS Prig. Request
No.. Street Municipality (T)(V)(C.) Compliance
_ Complaint Comp
MAILING ADDRESS Final
P.O. Box Post Office Zip Code Group Illness
_ Construction
TELEPHONE
PERSON IN CHARGE
OR INTERVIEWED
Name,and Title
DATE
TYPE FACILITY
_ Reinspection
Field, Sampling Only
Field Conference
Other
TIME ARRIVED TIME LEFT Explain
INSPECTOR:
Sirknature` and Title
TELEPHONE:
PERSON IN CHARGE OR INTERVIEWED:
I acknowledge receipt of a copy of this SIGNATURE:
Field Activity Report ..................
TITLE:
i
� t
1 ,
Tit /e to the 4 ft. wide strip she
° be in question due to the word.
description of lands conveyed tt
Putnam Valley in L/ber.J61; Poy
Contrary to the intent depicted
CP
X10' No. 802 ( referenced in said de
now or formerly N DA WD & L YNNE PONDER ''► are vdesc :a the Tpxt n Llbeh .
ore described as, °extendrhg the
u ( Liber 1147, Page 209) Q� each said property and being lc
LOT ` depth. expert and bont on on
A title expert shoo /O be consu /t
any /imitations of title to this
FRAME HOUSE;
concrete and brick walk 9>•ot,a, °••
"wiles ,...�.. _..,.. •_, '
overhead :.`
�� _l'2 outside` I wood retahMg wo// 0.9' Inside ( current geed a 22742) �*� 0
masonry stone g� ..w/ stockade lence .
C — retaining wall s ., l.2 /.J' 130. 13
°OS�OO'. E _ _ q
8. J' 1.0 rr stockade •� post , and rail U !cote .. ? 'T.�� '�,ypSIn
o e block walk -0.6' inside ' F"'.
block w0 /k l/— �•
stockode� �!chim. q 1.0
O a portitlon ; 1 o N inside ;! _J / rood /ate as per F.M.NO. 801
.c /// /// i an p y sK,.
2 t: o original southeaster line of lots shown -�" 't
o O o y c
3 c /, on -MO o/ Loure/ Wood Manor' deed ��` \ .5 ov 'OO E
u 2 O e N / .. 40 , 67' \ lands deeded to tt
p 3 2 wood rot. wall c a o Y �} ( current deed = 44.J9') Valley by carious o
O m ° // !� _ - Liber 361, Pg. 5J!
520• , FRAME 36 - - _ asphalt and shown on FW
,� %' % ���
O ` a
LOT `t / ' a`e Mood -F�! tr e �' a` pavement
c WOOD HOUSE r a.. wa /kw op o
o i cry gl
DECK \ and
CX
u J ' o tz t , t / 14, coon : _ , y \ / rood /are os pa F.M. Na
Q C t i t t t to oa . /. o o
W v o a mos. stone toe d° S 70°08'00„
�, Sto,, rot. `wall t �c 33' ad "•or m
O o iron pipe found
E g - i ka o - - •f
n o 21.81
of masn ole /— U B //� C ret. wy m -
CL 21.98'
` 3J'-� fence 0.3' es 1 248.36 bosh
a :b' 4.1 °O.1 00 W outside 4ir \\ \111
. —1 deed = 249.66') /
concrete
Q ` \�,Porch 1.9 � � Slab 6.0' outside /
W outside. ; o
I, O T .5 2 FRAME HOUSE".,* �
U W /ands deeded to the Town of Putnam
c o W Valley by various abutting owners in
O Liber 361. Pg. 5J9 -541 of deeds
o now or formerly N MARTIN FELDMAN & SIL VIA HAFL #R and Shawn on Filed Map No. 802 fill
T.,
( Liber 1695, Page 456 )
J
I h LOT 22 •
a'........ .
;o
to. 25.24' measured to hole in rock found
h;a 15.85' measured to cross cut found
?`
stone
+
Z5_24, ... ..:
s 37-6' ° E �s cut and AREA = 0.2858 ACRE
i[o<r an hole in rack
nd ,lane wall (
12,448 SO. FT. )
^' ARMSTROiyG .
got'
Ga�� �
2
2 92,
,
7-Al
K15�l
OL
I K.4N
ii
/y = l
G0�?Ce-t�n��ct I e.Cv
Opt I /Os%q
��GtU ��y- Sz 3- 92- 1'�
I, w,, Ow 01
1 �-� Uv
�Rk o If