The URL can be used to link to this page

Home My WebLink About3026DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631 - 589 -8100 62.18 -1 -35 BOX 25 03026 Ll �r 16 is ow r J; AM to 03026 OWNER'S NAMS SITE LOCATION MAILING ADDRESS PUTNAM COUNTY HEALTH DEPARTMENT . DIVISION OF ENVIRONMENTAL ._ .. w.�_. , ...... , ... _., ... ..,.- .._... _, HEALTH SERVICES PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR DATE PCHD Complaint # .el owner, tenant, etc.) TYPE FACILITY �' 1 REGISTRATION # r Prcposal-(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 fron licensed professional engineer or registered architect. �D S v lvc XNX wta s S1Qnatufel & Title 7/24a Date toposal 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. c. Location of installed canponents tied to two fixed points (e.g.,house corners). d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep drywells surrounded by one foot + gravel). e. Installer's name and number. 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. SIGNATURE TITLE J? G' L DATE M: *dbe (PW); YeUcw (fin gI ); Pink (Ani i®nt) PROPOSAL FOR SEWAGE DISPOSAL SYSTEM PMAIR MM ' S NAPE F `". �" 9 ° V PRONE G � SITE LOTION I J ivArl J 7i�1# MAILING ADDRESS C PMON INTERVIEWED `P/!n PCB CagDlaint Name & ationship (ice, owner,tenant, etc.) DATE TYPE FACILITY �j PROPOSED INSTALLER PHONE REGISTRATION # . Proposal (include sketch locating all adjacent wells): NOTES 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. approved I. Proposal Disapproved 's S�gnatitfe' & Title .5X 7,92 a Date Proposal approved with the following conditions: to Procurement of any Town permit, if applicable. 20 Submission of as built repair sketch in duplicate showing: a. Owner's name. bo Site Street Name, Town and Tax Map number. co Location of installed components tied to two fixed points (eogo,house corners). do System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep dryw+ells surrounded by one foot + gravel) ee Installer's name and number. 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. SIGNATURE TITLE DATE o Rite MCED) o Yel lcw (Tan SI) a Pink (Pjtirez t) ro �- $�t a�lJ� 1 Name & Relationship (i.e, owner tenant, etc.) DATE V� Z' TYPE FACILITY PROPOSED INSTALLER , a �- z'r .� PHONE '� �, y• 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. Proposal a ed Proposal Disapproved V//6 /,? 2- - Inspector's Signature & Title Date the following K ECEI �U Proposal approved with conditions: 1. Procurement of any Town permit, if applicable. APR 0 J 2. Submission of as built repair sketch in duplicate showing: 19 ,9? a. Owner's name. PUTNAM b. Site Street Name, Town and Tax Map number. DEPT COUNTY c. Location of installed canponents tied to two fixed points (e.g.,house corde4f. HEg4Ty d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6 deep drywells surrounded by one foot + gravel). e. Installer's name and number. 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, or reported agent of , owlner agree to the abo1ve1 conditions. SIGNATURE r Y ( Q G "VA t9'. TITLE V �V �� e/L DAB PIES: W-dbe (FAD); Yellow Umn HO; Pink (Aniiamt) o SITE MAIL PERSI DATE PROPOSED �V JZ,(4( '�TO , Dame & Relationship (i.e,, owner,tenant, etc.) �-' TYPE FACILITY Proposal (include sketch locating all adjacent wells): NOTE. Repair must be in same location and of same type as original swage disposal system. Different location may require submittal of proposal from licensed professional engineer or registered architect. Proposal a ed Proposal Disapproved Inspector °s Signature & Title Date Proposal approved. with the following conditions: CEIVED 1. Procurement of any Town permit, if applicable. APR 0 �.. 20 Submisgion of as built repair sketch in duplicate showing: 1992 a. Owner's name. PUT NAM N.q� bo Site Street Name, Town and Tax Map number. D TT DDDN Y �grL9r9fo co Location of installed components tied to two fixed points (eago,house HEg4r do System description (e.g., 1250 gal. concrete septic tank, three precast 61 diamo x 6 p dry ells surrounded by one foot + gravel). ee Installer °s name and number, 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, sIGRNTiJRE f Y ( r ✓f +� ( +� i' "✓� � �� TITLE L L) i� ✓+� - ATE 'moo mite (&SID) a yellrw (Tam RI) o Pirk Dni iamt) lit IJ. 1r�.. / J NCIRNAN ANIAJ-:1-ON i'Ni PUTNAM V;*iLLfr_%'-, v i 4- E'STI-MATE,', FOR A 3:7. 00 1-*EH-*,' F; jk t:) PUMP WCONTRU--- 11 F'j:TU':S.ci (WAPTON' '_QR9.LjE OF" M Isc - 'I L., C 1F F I,-- i lil It 75' H 1 FL..I-'--'X R T f: Blc, 12 G e-) U G (2,kj PUMP WARPENY'Y 5 YEAF�"_:' wi ESC A v A T 10- N Fl-n"o' CA) OPE* L I E I MAI E DABi': Ll L It,; 2 1 cl t7S:2.T t76, 82 Wnf Ed Jt, . . . . . . . . . . A5,,& 'Ib fot J 46 k� �f Drdii& -ENM Ow VA Pam sket& lcmtijag aU adia=t wals) . . . . . . . . . . oil Am- A5,,& 'Ib fot J 46 Ow VA Pam sket& lcmtijag aU adia=t wals) *r mst bi in sm location arA of ww�iypa as origiml a Nk AWN, .,,!aN_RN u tm a lz .. lltiW4 9tiuAl tm 4 leo, oil Am- ;: ... -:.:* . DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 APPLICATION` TO ,CON`STRUCT . A WATERY -WELT: .. iC% PCHD PERMIT / 6 WELL LOCATION treet A dr s . o Villa City_ uYL°�x Gxid o Numbe , WELL OWNER Name Mailing Address r D Public USE OF WELL primary 2 - secondary 41 RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION D INSTITUTIONAL ❑ STAND -BY O ABANDONED ❑ OTHER (specify O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE_,gal REASON FOR DRILLING 10 REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION Cl-ADDITIONAL SUPPLY ❑ NEW SUPPLY NEW DWELLING $ DEEPEN EXISTING WE L DETAILED REASON FOR DRILLING ✓ h1 0 WELL TYPE DRILLED DRIVEN OUG OGRAVEL Q 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 bbz-rYqy\A '1'�IYY"�O.v��v Address : IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES t/ NO NAME OF PUBLIC WATER SUPPLY: N//`t TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: �(i /� T.nrATTnW RWRTrW & gnTTRCRR nv rnKTAMTNATTnN PROVTnP..T) 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 m nner as not to degrade or oth wise contamina a surface or groundwater. Date of Issue• x 2 19� Date of Expiration 19 Permit Issuing 0 fici Permit is Non - Transferrable White copy: HD File P k copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New .York 10509 +� w 4 l 2- - j 00 (914) 278 -6130 APPbkhCA�:hON..T0- CONSTRC ICT:` Ac�WATER .rWELL�-....._..:,:�..,,:.•:r. w �� J PCHD PERMIT 0 rV 21 / WELL LOCATION Street. Address(p7evo,4A,,)ToG7VillA ' � : �� City Tax Grid Nu ber -v,-d 7 ` a "Ike El? CCU 6I )9. WELL OWNER Name Ma 1ng Address rr �Q'�a�} VS(0 4v p U) 'M a7' �i�GY'St�i �tiL /V�� Private �(o OPublic USE OF WELL 1 - primary 2- secondary G RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL ❑ PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION U INSTITUTIONAL O STAND -BY 0 ABANDONED, O OTHER (specify O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE__gal REASON FOR DRILLING 0 REPLACE EXISTING SUPPLY O TEST /OBSERVATION M ADDITIONAL SUPPLY O NEW SUPPLY NEW DWELLING O DEEPEN EXISTING WELL DETAILED ' REASON FOR DRILLING 0 1 ca o .. ' ± e A" S / e WELL TYPE DRILLED 13DRIVEN DUG [:] GRAVEL. C] OTHER IS WELL SITE SUBJECT TO FLOODING? YES ,"NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. ,1 �I i WATER WELL CONTRACTOR: Name,40 li%S D ) U'r/r • V,,, � Address :Bg P4.4 5•Pezf' IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES t,� NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE •TO PROPERTY -FROM NEAREST WATER MAIN:... LOCATION SKETCH 6 SOURCES OF CONTAMINATION O ON SEPARATE SHEET (date) PROVIDED r (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 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 surface or groundwater. Date of Issue: Date of Expiration Permit is Non - Transferrable 3/89 19 19 Permit Issuing Official White copy: HD File Pink copy: Owner Yellow copy: Bldg. Insp. Orange copy: Well Driller 1A1 qrc- r4- , 12,#100 DEPARTMENT OF HEALTH Division.of Environmental Health Services 110 OLD ROUTE SIX CENTER, CARMEL, N.Y. 10512 (914) 225 -0310 APPLICATION.TO CONSTRUCT A WATER WELL PCHD PERMIT � ALL LOCATION Street Addres J S Town Villag Ci y or Tax Grid Number WELL OWNER Nsme l+�ailing A ddress Private ®Public USE OF WELL 1 - primary 2 - secondary eRRESIDENTIAL' 0 PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP ® ABANDONED 0 BUSINESS O FARM O TEST /OBSERVATION 0 OTHER (specify, ® INDUSTRIAL 0 INSTITUTIONAL 0 STAND -BY O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. REPLACE EXISTING SUPPLY 0 TEST/ OBSERVATION ON EW SUPPLY NEW DWELLING) ® DEEPEN EXISTING WELL Lvf LL 0 / I5 oKJ74-4/'Il OF DAILY USAGE__Sail 12 ADDITIONAL SUPPLY T 'U REASON FOR DRILLING. DETAILED REASON FOR %CLING 0 sro v-rDR 26420 WELL 'TYPE WDRILLED ®DRIVEN DDUG ®GRAVEL 00THER IS WELL SITE SUBJECT TO FLOODING? YES ----'NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: ---- -- Lot No. 'HATER WELL CONTRACTOR: Name AAPyQz56yJNor% 6Pvf' Lg,*J�Address: c12. YS.PUBLIC MATER SUPPLY AVAILABLE TO SITE: YES NO WM E OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN LOCATION SKETCH & SOURCES 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 thirt3: (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 ydrill g operations b e contained on this property and in such a manner as not to degrade or seccontaminate surface or groundwater. Date of Issue: 19 Date of Expiration % 19 ssuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller b� .. MARVIN O'DEL> "`f.:..: -_.•. ... , _. .. . r. ..:...�, �• Bldg. Inspector TOWN HALL ,... ,. _ � .,: r:: �,Y... :<_:.....- ..�,y�PU7NAM'VALCE'�Y TV.Y.W "•.., :.s (914)526 2377 JOHN MAHONEY TOWN OF PUTNAM VALLEY Deputy Zoning Inspector BUILDING, ZONING, AND SANITARY DEPARTMENT January 10, 1992 Department of Environmental Health 110 Old Route Six Center Carmel, N.Y. 10512 BETTE STOCKINGER Bldg. Dept. Clerk Att: Bill Hedges Re: Proposed new water well Muscolino, Paul 15 Laurel Wood Lane TM #62.18 -1 -35 Dear Mr. Hedges: The above noted proposal has previously been reviewed by our Town Board and approved with conditions listed on attached copy of Resolution #R -100 dated March 28, 1984. Should existing conditions remain unchanged, t is_ .. . . app v_ - .._. -. - .... Yours,ttuly, , z/aw-A K MARVIN 0 DELL% Building & Z ing Inspector MO'D:es enc . - S;'AL`IEX1'MER �s9a= 5aa =a�2� +fir, 04 J., ; y Clerk' } w r..-P.ATR1CIi� "P`ET7ERSEN:"'- �:•.,.��. ... (914) 526 -3280 - TAM SALVATORE SANTAMORENA " ' .y'i rV $'..'M1yP• Council man HOWARD D. ARONOW Councilman JOSEPH M ARRO Town Attorney TOWN OF PUTNAM VALLEY Councilman HERMAN TAUS (914) 526-3050 R.D. 2, Town Hall HYMAN RICHTER Putnam Valley, New York 1079 Councilman �� a2 -all TOWN BOARD MEETING MARCH 28, 1984 n Presented by Councilman Aronow:. RESOLUTION #R -100 :•JHEREAS, Dr. Paul Muscolino (TM 52 -2 -24) has an existing well and this well has become contaminated and the septic system is 10 to 15 feet from the existing well, and WHEREAS, Dr. Paul Muscolino wants to relocate his well to a point near his garage as shown on the survey submitted by John S. Romeo,'P.C. P.E. & L.S. but it is very difficult to upgrade his septic systen because of its location, now THEREFORE BE IT RESOLVED, that the:Town Board of the Town of Putnam Valley approves the following: 1. Dr. Muscolino must upgrade or replace existing septic system prior to installation of new well and upon approval from the Building, Zoning and Sanitary Inspector. 2. Furthermore no expansion of the existing residence to add additional living quarters shall be permitted based upon the inability to expand the existing septic system absorption area. "� 3' '' Theme existing well 'shall be-filled with concrete as approved by the Building;" ~�• #�{ Zoning.and Sanitary Inspector, The''new` septic�•systemi is to be designed by the applicants engineer and y approved by the Building, Zoning and Sanitary Inspector. 5. Wall to be rebuilt to satisfaction of the Building, Zoning and Sanitary Inspector.. 6. This Resolution is to be filed in Carrel with the Deed. Seconded by Supervisor Sypher; unanimously carried. i. i BEFORE THE ZONING BOARD OF APPEALS USER 760 7a(E1 S 7 i TOWN OF PUTNAM VALLEY :PUTNAM COUNTY. NEW YORK. - „ ...,.. :... t _/� r. ... »... .. --.. IiJV� DECISION & ORDER !YY I Name or Applicant or appellant: Dr. Paul Maecol'ino Pp j 04 1 Address: 880 Post Rd.. Scarsdale, N.Y. 10583 CLERK'S OFFICE Date of Request for Hear' Form' 8/17/81 Date of Advertisement: 819/81 in rODFpttTptITY CURRENT PUlhk,! CUU„!Y LLatn' `Uirl Location of Property: Columbus Ave. Zone: R -L RECEIVED Ott THE. 1..._.Nv OF_. Nature of Request: Following variances to erect 16' x 30' docks BOOK tio._'11.a.....OF._....Q. L 59.00' N.E. front; 57.00' N,W. front. I 1 AT PAGE.— !Uli,J,;;ge(u,;IHED Date of Public Hearing: . 8/27/81 Place of Hearing:' Town Hal, OsL:awana Lake Road, Puma Valley, N.Y^ �v MEMBERS PRESENT: HWARD,D. , ARONGW Chaimfan ol'the Board FRANK MONACOr Member . FiER,aERT.LEVENSON•,, ._ ViCeCffalmLan. SAM. FRIGDMAN,,Member. . ............................ ....... Secretary w2 :. ............ The matter having duty come on to be heard before a:dutyconvened meeting of the Board 'on the 27thjay of Aug. , 19 81: and all the facts. matters 'arx:f vvidenco produced by the applicant, the Zoning Inspector and interested parties having been duty heard; received and consloered..and due deliberation having bean had, the following decision is hereby made: (�RDERF.D..Ihaf the a plirat-0 br,i eat be and'the'samG f+errny' i %Granted. 7Q7pCtyC JLwjC9�f The decision of trine, ing inspector.is' -he p%""reversed. 1 ..Thercf,'lre.,t Is OPQEFRED, that a permit as appseo (Jr tM!5sued provided Lnza app : +caton for the permit at applied for is .� made to the Zoning Inspector within one (1) year from the date hereof AppLcaton may be matzo within thirty (30) days after the expaatlon of said one (1) year.period, to the 2onmg Board of Appeals to extend the provisions of this order for a further C—nd of nr.a (1) vrar aeon ea• /me ^.t of a fee or $10.00: I After due deliberation,.the Board found .the following factst ! The grade. slopes from the road to the''`hou'se.' The °deck will give him level area for outdoor•sitiing. The existinq'driveway is a considerable distance from the proposed deck.' Variance request is not excessive and'will not be detrimental to the neighborhood. ' THF.RFFOAF.,'ba-,zd.on the above facts, variance is granted, ! TU,,,'N OF PUTNAM VALLEY - The property deseribed,in' the within variance is i known and designated as more particulazly'`described in deed dated March 17. 1973,recorded'in the Clerk's office "'ot the County of Putnam, May 18, fi 1973 in Rook No. 710 of-Deeds on oaoe`132' ?M 52 -2 -24 1 I RECORDS RETURN TO PATRICIA Pfi1TERSFiN, TOWN CLERK. lI: (1) The Building Inspector of the Town of Putnam Vaecy shall have the rigrd of entry to"premises effected by the within variance without notice or Con$ent :al all reasonable MMS. : (2) The within order shall not become effective ur4!I and unless there is filed w +m the Cift of the Zoning Board of Appeals 3 ..,,..... :. copies of the athnn Oder with the consent conlat ed hetext Ouly executed by the owner of owners of_ the .sut*t prenksas _,...- and a0rowfedgud Wore a notary public and returned t0 lhti'Ckrk;NtfTln 30 days. • >. Apply to E1-ilding Inspector for a Wmit before Wove "wah'ary nark., - N Dated. Putnam Valley, New York this 318t day of August 11181 Filed. Office of the Town Clerk ' Putnam Valley, Putnam County, New York,{ on 1he r{ dayot' t .19P �.... ....itt.a.6.x.a�,..... ' . .....' .....�>�Q........... I STATE OF NEW YORK, COUNTY OF PUTNAM W: STATE OF NEW YORK COUNTY OF u: On the $Ad. day of Sept. 19 81. before `On the day 19 beige. ' me personally came HOWARD D. ARONOW 'me personally came Chairman of the Zoning Board of Appeals of the Town of tome known to be the individual described in and who Putnam Valley. Putnam County. N.Y.,do me known to be executed the foregoing Tnstrumera. and acknowledged the individual described in and who executed •iris tae• that executed the acme. going Insfrt>+t\Ant; anQacftrlowfedged MU he ex ad , Life 6iNhDi ��L1[, sTAT( Cr '+1'N TOPee f WALIWO IN rutr+AM cowaf W ^'�'� CONSENT. Ho. 4607100 ' e (fin ulYQs approve and consent to the condnbns h,r ++.gat n s set tonh• a v� .s : as vnat the within I consent shall: upon the und0rsi an undersigned. cr` + OV& OxBCulor6, adm;n +sliwprs, succes=6 and ass I ins a! the ; �( OatOd' ' \tit .•.. •i 1 Jyry,., (, ' ........ " ....... ..,` 'b A Supervisor SALLIE SYPHER. (914) 526 -2121 �HOWIARD, D:, ARONOW - 'PATRICIA PETT,ERSEN (914) 526 -3280 4e;, Councilman: Town Attorney HERMAN TAUB (914). 526 -3050 TOWN BOARD MEETING MARCH 28, 1984' Presented by Councilman.Aronow: RESOLUTION #R -100. NHEREAS, 'Dr: -.Paul Muscolino .(TM. 52 -2 -24) has.:-an 'existing well and this well has become contaminated and'the'septic systen is 10``t6 15 feet from the existing' well, and. WHEREAS, Dr. Paul Muscolino wants to relocate his well to a point near his {� garage as shown on the survey submitted by'John'S.-Romeo, P.C. P.E. & L.S. but it is very difficult to upgrade his septic system because of its location; now'd THEREFORE BE IT RESOLVED, that the Town Board'of the Town'of Putnar. Valley approves :i the following. =. 1. Dr. Muscolino must upgrade or replace _'existing septic system prior to • installation of new well and upon approval from the - Building, Zoning and'Sani tar y Inspector. 2. Furthermore no expansion of the'existing residence to add additional liv_in g quarters shall be: permitted based upori',� -the inability...to expand. the existing , septic ° system" absbrp'tion' art:'a:.- a....._.... _ .._ ._.:. _._......_... -.. - ... .. 3. The existing. well' shall be filled with concr; -re as . ppra4rcd by the .Building, . ...�••••.•.... •.0.,.7 Cori.i.t�rts :SncnoC].t ('l Y,. .. OFFICE OF THE TO WN CLERK have compared 'the preceding or annexed copy 'of RESOLUTION #R -100 TOWN BOARD MEETING MARCH 28,' 1984,.. with the original filed in *:this office` and' QO HEREBY CERTIM tha' same.: to be a correct' transcript therefrom and of . the whole of such original. IN TESTIMONY WHEREOF, I have hereunto subscribed '.my 'name and affixed the seal of said Town this 3rd .- -day of APRIL 19 84_ Town Clerk, Town of Putnam Valley: . pplicants engineer and ng,.Zoning -and Sanitary e Deed. 0 Supervisor SALLIE SYPHER 1914) 526 -2121 Town Clerk PATRICIA' PETTERSEN (914) 526 -3280 SALVATORE SANTAMOREN C6micilman HOWARD D. ARONOW C oruci l mail JOSEPH MARRO Town Attorney T®AA7�� N OF PUTNAM VALLEY Councilman HERMAN TAUB 99 !. (914) 526 -3050 R.D.. 2, Town Hall HYMAM RICHTER Putnam Valley, New`' York 10579 Councilman April 3, 1984 Dr. Paul Muscolino; 880 Post Road Scarsdale, NY 10583 Dear Dr. Muscolino, At the Town Board meeting of March 28, 1984 Resolution #R -100 was approved. This Resolution will'.be'.filed in Carmel with your Deed. Enclosed please find a certified =copy of the Resolution. Yours truly., A patLici.= Pettersen Copy of Resolution to Zoning.Board :'of''Appeals j. County Clerk's :`Office, Carmel, New York Tnspector.0 9Dell Town of Putnam Valley John S. Romeo,_P.C. P.E. & L.S. f, PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services REGISTERED MAIL CERTIFIED, RRR 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 February 14, 1989 Mr Paul Muscolino 1944 McGraw Avenue Bronx, New York 10462 Re: Well permit # W 86 -88 Muscolino, Columbus Avenue (T) Putnam Valley TM 52 -2 -24 ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr.. P.E. Director Dear Mr. Muscolino: The department is in receipt of further information relative to the above - captioned property from the Town Building Inspector, Mr. Odell, specifically, a plan prepared by John Romeo, P.E. indicating that the existing well is located 15 -20 feet from the existing sewage disposal system. r.. This plan also shows a proposed location for a new well approximately 85 feet from the existing.'sewage - disposal .sysiem:�-` ' : ~;.:.<;._ ... , w.....; _ _ ._.�.�...r.. � _. In addition, Mr. Odell has provided the Department with a copy of Resolution R- 100 concerning this property dated March 28, 1984 in which the Town Board approved a relocated well and reconstructed septic system for this property. Based upon the above, the permit W -86 -88 issued to deepen the existing well on this property is hereby revoked. This proposal to deepen an existing well located in close proximity to the sewage disposal system does not comply with the requirement to maintain a 100 foot separation distance between a well and sewage disposal system and because of the extremely small separation distance, 15 to 20 feet Iis considered a hazard to the health of the occupants of the premises. The Department will consider an application for a permit to construct a well in the location shown on Mr. Romeo's plan, near the garage. If you have any questions, please contact the writer at Ext. 304. y rul yours, hn Karel , Jr., P.E. erector, Environmental Health Services JK:pt cc:JK Files S rr per•ri sa- SALLIE SYPHER (914) 52E, -2121 71 bie, — PATRICIA PETTERSEN 1914) 526 -3280 E SALVATORE SANTAMORENA _Councilman HOWARD D. ARONOW Councilman JOSEPH M ARRO Town Attorney TOWN OF PUTNAM VALLEY Councilman HERMAN TAUB (914) 526 -3050 R.D. 2, Town Hall HYMAN RICHTER Putnam Valley, New York 10579 councilman TOWN BOARD MEETING MARCH 28, 1984 Presented by Councilman Aronow: RESOLUTION #R -100 WHEREAS, Dr. Paul Muscolino (TM 52 -2 -24) has an existing well and this well has become contaminated and the septic is system is 10 to 15 feet from the existing well, and WHEREAS, Dr. Paul Muscolino wants to relocate his well to a point near his garage as shown on the survey submitted by John S. Romeo, P.C. P.E. & L.S. but it is very difficult to upgrade his septic system because of its location, now THEREFORE BE IT RESOLVED, that the Town Board of the Town of Putnam Valley approves the following: 1. Dr. Muscolino must upgrade or replace existing septic system prior to installation of new well and upon approval from the Building, Zoning and Sanitary Inspector. 2. Furthermore no expansion of the existing residence to add additional living quarters shall be permitted based upon -the inability to�E;I nd..the.existing _ °.septic'system absorption "area. 3. The existing well shall be filled with concrete as approved by the Buildin?, Zoning and Sanitary Inspector. 4. The new septic system is to be designed by the applicants engineer and approved by the Building, Zoning and Sanitary Inspector. 5. Wall to be rebuilt to satisfaction of the Building, Zoning and Sanitary Inspector. 6. This Resolution is to be filed in Carmel with the Deed. Seconded by Supervisor Sypher; unanimously carried. LLJ '[Jr. Paul,4. Mujcoli no CHIROPRACTOR 7_ 1944 MCGRAW AVENUE STREET PARKCHESTER SCARSDALE, NEW YORK 10583 BRONX, NEW YORK 10462 TELEPHONE (914) 725-4844 TELEPHONE (212) 792-9723 September 27, 1989 John Karell, JR., P.E. Department of Health Division of Environmental Health Services 110 Old Route Six Center Carmel, NY 10512 Re: Well Permit # 86-88 Muscolino, Columbus Avenue (T) Putnam valley TM 52-2-24 Dear Mr.-Karell: Could you please specify whether I could build a well in the specified area without changing my septic system? Please send a new application, and will my original fee cover the ne.w.application?. Thank you.. Paul A. Muscolino PETER C. ALEXANDERSON County Executive ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. DEPARTMENT OF HEALTH Director Division Of Environmental , . ealth Services REGISTERED MAIL CERTIFIED, RRR 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 February 14, 1989 Mr Paul Muscolino 1944 McGraw Avenue Bronx, New York 10462 Re: Well permit # W 86 -88 -:� ._...,�„ _,. ,.�.... _... _ ... _.. ......... _. _... .. C..,•yi .,mot.., c. - t *en„ o _ (T) Putnam Valley TM 52 -2 -24 Dear Mr. Muscolino: The department is in receipt of further information relative to the above - captioned property from the Town Building Inspector, Mr. Odell, specifically, a plan prepared by John Romeo, P.E. indicating that the existing well is located 15 -20 feet from the existing sewage disposal system. This plan also shows a proposed location for a new well approximately 85 feet from the existing sewage disposal system. In additi-on,. --Mr Oder. Yiaso,_provided,-the Department with „a co - py o.. Reso u; _ori ;P. , _ ..:..... 100 concerning this property dated March 28, 1984 in which the Town Board approved a relocated well and reconstructed septic system for this property. Based upon the above, the permit W -86 -88 issued to deepen the existing well on this property is hereby revoked. This proposal to deepen an existing well located in close proximity to the sewage disposal system does not comply with the requirement to maintain a 100 foot separation distance between a well and sewage disposal system and because of the extremely small separation distance, 15 to 20 feet/is considered a hazard to the health of the occupants of the premises. The Department will consider an application for a permit to construct a well in the location shown on Mr. Romeo's plan, near the garage, If you have any .questions, please contact the writer at Ext. 304. rulA vours hn Karel 9.bNo.., P.E.._ rector, Environmental Health Services JK:pt cc:JK File Marvin ODell, Bldg. Inspector PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services =D,;,��, 110 Old Route Six Center, Carmel, New York 10512 (914) 225-0310 February 14, 1989 Mr Paul Muscolino 1944 McGraw Avenue Bronx, New York 10462 Re: Well permit # W 86 -88 Muscolino, Columbus Avenue (T) Putnam Valley TM 52 -2 -24 Dear Mr. Muscolino: ENID L. CARRUTH, M.P.H. Public Health Director JOHN KARELL Jr., P.E. Director The department is in receipt of further information relative to the above - captioned property from the Town Building Inspector, Mr. Odell, specifically, a plan prepared by John Romeo, P.E. indicating that the existing well is located 15 -20 feet from the existing sewage disposal system. This plan also shows a proposed location for a new well approximately 85 feet from the.existing sewage disposal system. In addition, Mr. Odell has provided the Department with a copy of Resolution R- 100 concerning this property dated March 28, 1984 in which the Town Board approved a relocated well and reconstructed septic system for this property. Based upon the above, the permit W -86 -88 issued to deepen the existing well on this property is hereby revoked. This proposal to deepen an existing well located in close proximity to the sewage disposal system does not comply with the requirement to maintain a 100 foot separation distance between a well and sewage disposal system and because of the extremely small separation distance, 15 to 20 feet/is considered a hazard to the health of the occupants of the premises. The Department will consider an application for a permit to construct a well in the location shown on Mr. Romeo's plan, near the garage. If you have any questions, please contact the writer at Ext. 304. uirector, Environmental Health Services JK:pt cc:JK File Nfar\7in nT1a11 Mao- TnRnPCtnr. PCJ'i`NAM" COUNTY 'HEALTfi `DEPAETi�tBN3` DIVISION OF ENVIRONMENTAL HEALTH SERVICES John M. Simmons, M.D. Deputy Camnissioner of Health - FIELD ACTIVITY REPORT - Sheet % of f NAME A V S a v INSPECTION Orig. Routine / ADDRESS CU Lviu � (-- V — Orig. Complain Orig. Request qo5 No. Street Town TH No. — — 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 Other DATE a ��' r3 TYPE FACILITY TIME ARRIVED .O b TIME LEFT Explain FINDINGS: / (- k� c �.,>(, (/✓ fi —�-l. (j D CA-•TJv� `.J �- fdL.jv �/ y �C.��S GcSZ^�_ INSPECTOR r TELEPHONE: Signature and Ti PERSON IN CHARGE OR INTERVIEWED: I acknowledge this Field Activity Report. SIGNATURE: TITLE: J "4?' DEPARTMENT OF.. HEALTH — �. Division of Environmental, Health Services 'TWO'CO _TY CENTER - CARMEL, N.Y.t 10512 (914) 225 -�64 PPLICATION , TQ .•, MTRUCT .Ay WA. TEJ. WELJL' \ PCHD PERMIT # - WELL <:LOCATION Street Address Town V llage Ci Tax kd�;L.er Ave PLI)-N QM 114, il Grid Number. WELL OWNER ., Name M'11,ing. Address RW� �( — 1i'% A V( n 0 rivate "' DPublie' USE OF WELL (1� primaty 2 - secondary . ❑ RESIDENTIAL "' k' ❑ PUBLIC SUPPLY 0 BUSINESS O FARM," 0 INDUSTRIAL b INSTITUTIONAL Q AIR /COND /HEAT IX14P 0 TEST /OBSERVATION' ❑ STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED_ /EST. !OF PAILY USAGE gal REASON FOR ''. ; ; NEW SUPPLY O VIDE ADDITIONAL SUPPLY ❑REPLACE EXISTING SUPPLY EEPEN' EXISTING WELL ❑TEST OBSERVATION S�M� /14L�� -,..-DRILLING. DETAILED ' REASON FOR . DRILLING °. 171 D WELL TYPE [3DRILLED :, = []DRIVEN DUG OGRAVEL OTHER IS WELL SITE - SUBJECT TO FLOODING? +;. YES '.._NO IF WELL JS, LOCATED ,IN A. REALTY, SUBDIVISION, NAME OF SUBDIVISION: "- ;.� ' Lot No. i WATER WELL CONTRACTOR: Name *�/1/,D SUAI Ad d :ess _ 1" IS PUBLIC WATER- SUPPt,Y AVAILABLE TO SITE: NAME OF PUBLIC WATER SUPPLY: NO ,. R j TO ^ /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION 'ETCH .& SOURCES OF CONTAMINATION,RROVIDED i1 ON REAR OF .THIS APPLICATION` ON SEA RATE SHEET ' ( (d s a ign e) r. to 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 Co4e .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 of the Putnam County Health Department attached to this permi 3. Submit a Well Completion Report on a form pAi coed by ,the Putnam. County .:Health Department. Date of Issue: "(, 19 _ Permit Issuing a Date of �.xpiration. . - v 19 � Permit is-Non-Transferrable White copy: H.D. File i Yellow copy: Building Inspector Pi* Copp Owner i, 1� ,V MARVIN O'DELL Inspector TOWN OF PUTNAM VALLEY BUILDING, ZONING, AND SANITARY DEPARTMENT February 7, 1989 John Kar.ell, Jr. P.E. Department of Health Two County Center . Carmel, N.Y. 10512 TOWN HALL. PUTNAM VALLEY, N.Y. (914) 526 2377 Rea Well Permit - TM #52 -2 -24 Dr. Paul Muscolino Dear John:. As our phone conversation on February 6, 1989 regarding -the above not property, find enclosed some history of record on file within our Town pertaining to water well and SSDS. Please note that records reflect the existing well to be contaminated and is located within 10° to 15° feet of a substandard S,ep_tic_.:Sy_st.ema.. - Please contact me if I can be of further help. Yours truly, MARVIN 0 L Building & Zoning Inspector MO °D:es enc. Town Bd. Resolution R #100 - 3/8/84 Report of John Romeo,PC - 2/27/84 Site plan- John Romeo,PC - 2/17/84 .Well Permit - PCHD: '-W86 -88 .(To deepen existing well) J �1. ItOMRU. 1'F.. 1.9 f JOHN S. ROMEO, P.C. CUN�IULTINO ENOINEERS & LAND SURVEYORS .. `I "NORT11RIDOE ROAD I- EEKRKILI.. NEW YORK 10800 814- 737 -1050 February 17, 1984 Dr... Paul Muscolino 880 Post Road ' Scarsdale, N.Y. 10583 Re: Proposed replacement well for property on Sec 52 - Block 2 lot 24 - Town o Putnam ValTy Dear Dr. Muscolinot As requested, I have again reviewed your property and added additional information on the sketch map concerning adjoining neighbors and their well and SSDS facilities. The neighbor to the southeast, n/f Citarella, has.a septic system in front of the house that will be approximately 80 feet from the proposed well location. However, it is on the other side of the road and not in line with the direction of flow. The possiblity of expanIng the SSDS behind your house can not be achieved. Their is rock outcrop behind your home, and I cannot believe any usable area can be found in that location. _ The only possiblity, would be to possibly construct some _ each pits beneath the wood deck area. These would still be approx- imately 90 feet from the wells located across the road (Lee Avenue) - -° - . toHowever-; --since y our se tic -s st-e-m- had been__o eratin g F rior_ , the contamination of the existing well, I would not expand the system unless it is found that the existing system cannot support the renewed use of the new well. The road adjacent to the east does not have any name that I could determine. _ As far as I can determine, the only person affected by the proposed new well is yourself. In no way, will this change the ...existing conditions, and in fact it will make your own situation much better, as it will remove a well from close proximity to your sewage disposal system, and put it uphill and approximately 85 ft away. I would recommend however, that if permission is granted for the new well, then the old well should be filled and sealed. Very truly yours, John S. Romeo P.E. & L.S. JSRi clr cce Mr. Marvin Odell, Building Inspector with enclosed sketch DEPARTMENT OF HEALTH �j Division of Environmental Health Services TIWO CO Y CENTER - CARMEL, N.Y. APPLICATION TO CONSTRUC T10512 (914) 225 -3641 A WATER WELL PCHD PERMITAl" -b� WELL LOCATION Street Addr ss C.I.Mbu,s q ta' 1 ee 40e- To � �llage Cit Tax � 6 z" Grid Number '111001 WELL OWNER Na(mf e M iling X � � Address c a0-* W rivate ❑Public USE OF WELL � primary 2 - secondary ® RESIDENTIAL ® BUSINESS ® INDUSTRIAL ❑ PUBLIC SUPPLY ❑ AIR /COND /HEAT ❑ FARM ❑ TEST /OBSERVATION O INSTITUTIONAL ❑ STAND -BY ❑ ABANDONED ❑ OTHER (specify AMOUNT 'OF USE YIELD SOUGHT gpm /# PEOPLE SERVED 3 /EST. OF AILY USAGE gal REASON FOR DRILLING ONEW SUPPLY OREP14ACE EXISTING SUPPLY ❑ VIDE ADDITIONAL SUPPLY EEPEN EXISTING WELL ® TEST /OBSERVATION DETAILED REASON FOR DRILLING W ew faceW AE 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� Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES N0 NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ON REAR OF THIS APPLICATION DON SE RATE SHEET (da 1 (sigUaLu re)� � PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provi sions of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and proviidei that within thirty (30) days of the completion of water well construction, the applicant shall: Date Date 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. of Issue: A 19 � �s � c)f Expiration: �u C % 19 � /) hermit Issuing ffi is White copy: H.D. File Permii tis Non- Transferrable yellow ° Buildin Insrwh"*r 2/87 copy. Pink Copy: 4 Owner Well Driller DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 t APPLICATIM TO CONSTRUCT A WATER WELL PCHD PERMIT #ICI )/9 f WELL LOCATION IS WELL SITE SUBJECT TO FLOODING? YES 4- NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name W0,f✓h,,jS►, ¢jJbj)E,?1'o All I/YC' Address: / IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES e—_NO NAME OF PUBLIC WATER SUPPLY: Ill��4 TOWN /VIL /CITY DISTANCE- TO- ''TROPERTY� FROM- NEAREST- WATER, MAIN • _ LOCATION SKETCH & SOURCES 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 drilling operations ned on this property and in such a manner as not to degrade or otherwise a n rfac groundwater. Date of Issue: 19j�� 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 ,,/-Street 2,,dress /l� T Village City Tax Grid Number G 'A m l h 1v'. � i � - / -- SIS WELL OWNER Ma .1. Address QPrivate O Public USE OF WELL 1 - primary 2- secondary fa RESIDENTIAL 0 BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY Q AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION O INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT S6' 0 gpm/ # PEOPLE SERVED --/EST . OF DAILY USAGE U gal 13 REPLACE EXISTING SUPPLY O TEST /OBSERVATION Q ADDITIONAL SUPPLY O NEW SUPPLY NEW DWELLING 13 DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING G I A-64 L7n/L + i - T a el - eo WELL TYPE DRILLED DRIVEN []DUG GRAVEL 0 OTHER IS WELL SITE SUBJECT TO FLOODING? YES 4- NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. WATER WELL CONTRACTOR: Name W0,f✓h,,jS►, ¢jJbj)E,?1'o All I/YC' Address: / IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES e—_NO NAME OF PUBLIC WATER SUPPLY: Ill��4 TOWN /VIL /CITY DISTANCE- TO- ''TROPERTY� FROM- NEAREST- WATER, MAIN • _ LOCATION SKETCH & SOURCES 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 drilling operations ned on this property and in such a manner as not to degrade or otherwise a n rfac groundwater. Date of Issue: 19j�� 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 07/21/1994 14: 27 FR0t9 TO 52,2,130- P 02 DEPARTMENT OF HEALTH r' Division of Enviro=ental Health Services ; . ' ' 4 •: Geneva .Road, Brewster, New -York 10509 60?'. 4� :.. _. • __ (914) 278 -6130 IS.V= SITE SUBJECT TO • P�OOnYNCa , YES IF WELL 15 LOCATED IN A' REALTY SUBDIVISION, NAME -OP SUBDIVISION: - .v,.. Lot Ho. 'IiATER bL �iCTOR:;' N81. '' "f Qj Address: IS PUBLIC VATER:SUPPLY AVAILABLE;,TO SITE: YES Fip ��}}pp��gg g�77-//�� yy�`:' q- �,•�':t{3�:,...r� ^,}'-�.;n. .: �yv �',v�'.'.: .�. fJ'fG'� .;.rrYlry .'.. '' \:. .. /��,.yp�' `may' p+ITT..; Fi��yyy 8/bV.P�tL ::�3.. TVWl9 /G 161�VI,i,t r. •. Jr r. T'lI ./!� •:: :•.. ,,.. .,H ._�,:�:;e.,•.,'.t troy.•:. _.:�:1::;'Sa••'•'r�-.^r'A.: •s.; ibir.:.k.ti;. \.,r k1. ri'- '' \'y:��,.• "r DISTANCE DISTANCE ,P61VSAA.L6 Q8ti0W WEAREST•,�ATSiA ;l7pip, °'••r'+'- .,y` y,�:,ii: ', ..LOCATION SYMCE -':& SOURCES,:•` 4�. , ®F:..;��y. NT�aMINATION �ItOVIDED .. :} r., , e•, �,r'>•",•iE:•:£•a:�rv�•' \�•�ri: �.:•''�ryr1�•<:;.. tr� \,;,•• , °• :y'. Li ON, SfiPARATE�l ",.. . ..fin :3• A�(�M:• V , is ;:Y !A: dC. ry1 .; '. v ;.. w:'. :r'- ?p.`�[f.£wCy..\.•,', ^.4. ...i'1:r •�• .V •r!'d;: • - • : ' :. : �.'t.;,.; ... ;:.: •::.:::'• . � }" :.'::..:`" ' i ; is '.. !' .. PERMIT TO'!CONSTRUCT A'WATER WLLt 'This pe It .ao construct i i ..one,,; titer xell as -seE forth • above is granted 'raider,• ° &he psovi ions of •Subpart "5 -2 of .Past `'5. 61-"the' Vpw York State �Sanitaay, Cgde,''and' provided that,: rithaa► thirty (30), . days_,of..;the .con1 Iet;Lon . of water*: Drell consttuction a the : "app l,icant;';sha� l 1 ° Pwnp',:he ":weXl; until Aid',.water is clear. :''; .: •;i;''•` 2. Disinfect •tiie, tr kgccog3atice" w tZie requs em es a -Futqa1q `Ca=cy. Dep�gtmene_$tached ';for :this ': permit ° �:•, ,.., 3. Submit a' -4611 •Completi&' Report on a form. provided 'by the Putnaz .Couat&y Health Department .During.all Drell:drilling'operations, the,applicant shall take, appropriate 'aOion Io.,assure that any and all water.osc'waste products from such well dgilling'op Fations'be cmta3 ed'on this;. property and in sucfl a nes as not to degrade og otY� Vise eonganliaa g'. $ugfAae or.' groundirater. ' r Date of Issue: ` 19 Date of Expiration 19 Pe�xt Issu#.g fic I Permit is Non- Transferrable. White copy: RD File P copyo_Oener 3/89 Yellow copy: Bldg. Insp. 'Orange copy: Well Driller i^x •*7Ai" 2-4 C) z /ml 0 P 7 51 fi , _22 k 91 IC U4, WELL i46t) SE. c x, 'ELOAIGIN6 To FAbL �'IUSCOLINC? 9- ��At€'AbT' 7*0 S(AC APPROVED BY: DATE: 7owm or %IALLF-y Pe)r.NA/"� COUN'rlrl.. NIEWYOPM JOHN S. )Rcv-:,,F-O " PE. • 27846 ��oF Near von DFIAWNBY J3(L REVISED DRAWING NUMBER