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Home My WebLink About4081DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.72 -1 -15 BOX 31 imirs W I &A III I I r " .ti y 1 1 , ; ! !r riv !� I or Itr 1 . T 1n1: PETER C. ALEXANDERSON County Executive DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Rudolph Kemperle 75 -05 64th Street Glendale, New York 11385 Dear Mr. Kemperle: September 14, 1988 i Public Health Director JOHN SIMMONS. M.D. Deputy Commissioner JOHN KARELL Jr., P.E. Director Re: Proposed Well Construction - Kemperle 12 Ridgecrest Road (T) Putnam Valley TM #92- 5- 1'2 &13 Review of an application to construct a well for potable water supply purposes to"serve the above property has been completed. Review indicates as follows: 1. The lot is presently supplied by the Lake Peekskill Water - ..W.o.r k s _..w.i th s>> mmp -r._a. ter- 2. The lot area is approximately 13,000 square feet or 3/10 acre. 3. Any proposed well location would be less than 100 feet away from the disposal system on your lot. Recognizing the above and that a minimum restrictive distance of 100 feet is required between a sewage disposal system and a well, your application for a permit to contruct a well on this property is hereby DENIED. Very truly yours, Lawrence C. Werper Assistant Public Health Engr. JK /jz cc: Building Inspector, PV r� 6 b� DEPARTMENT OF HEALTH Division of Environmental Health Services TWO CON Y CENTER - CARMEL, N.Y. 10512 (914) 225 -3641 APPLICATION TO CONSTRUCT,,A,WATER WELL Q PCHD PERMIT # , GC /Dt' WELL; LOCATION Street Address I2 'Rj'te Town/Village/City Tax Grid Number �Re, ,le�e.f�ec�s`l1 .✓. 9.2- 5— /2,0�� /3 WELL.. OWNER Name Mailing Address %S': a5 l/3d's rivate • .. []Public USE OF WELL 1 - primary 2 - secondary A RESIDENTIAL O BUSINESS ® INDUSTRIAL ® PUBLIC SUPPLY ❑ AIR /COND /HEAT PUMP O FARM ❑ TEST /OBSERVATION 0 INSTITUTIONAL ❑ STAND -BY ® ABANDONED ❑ OTHE_R,(specify ®_.. AMOUNT OF USE YIELD SOUGHT i gpm /# PFOPLE.SERVED /EST. OF DAILY USAGE S'DO gal REASON. FOR DRILLING.. )R NEW SUPPLY ❑PROVIDE ADDITIONAL SUPPLY ..0 REPLACE. EXISTING SUPPLY ® DEEPEN. EXISTING WELL ®TEST OBSERVATION DETAILED; REASON FOR DRILLING /Vo V,?�u .. SU %� 'f e irkfe WELL TYPE DRILLED aDRIVEN ^. E]DUG ®GRAVEL []OTHER IS WELL SITE SUBJECT TO FLOODING? 'YES K NO IF WELL IS LOCATED IN A REALTY SUBDIVISION ;.NAME :OF SUBDIVISION: Lot No. -WATER -WELL CONTRACTOR: Name Nor,,540 - An4�e�so c, /hc. Address :,�a , S� f'�u �o a, i�'q //e IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: x YES NO NAME OF PUBLIC WATER SUPPLY: ,�o�e �e(J�-u . /ni,P� due f- TOWN /VIL /CITY / Z,0 10579 ~'DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: 4c�o�s Sd�ee f LdCATION SKETCH &SOURCES OF CONTAMINATION PROVIDED OON REAR OF THIS APPLICATION 0 SEP T HEET (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 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 2/87 ermit Issuing Official White copy: Yellow copy: Pink Copy: Orange copy: H. D. File Building Inspector Owner Well Driller 4 :,i 4 NI , 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 9 !J PCHD PERMIT. WELL LOCATION Street Address Town _Village ,,City Tax Grid Number... /I i.6tc9E37 ^/g 10S-3 WELL OWNER Name` 1Pv.�mtPN EMPERs6. Mailing 'Address trPrivate '%;"O� 6 S:• G� =��AcF N 113 PS' O;Public UgE OF WELL primary 2 secondary RESIDENTIAL 0 BUSINESS [YINDUSTRIAL ® PUBLIC SUPPLY Q AIR /COND /HEAT PUMP. ® ABANDONED 11 FARM. p TEST /OBSERVATION 0 OTHER (specify M INSTITUTIONAL .® STAND-BY.®.:: .. AMOUNT OF USE YIELD SOUGHT_ gpm /# PEOPLE SERVED /EST. OF DAILY USAGEXI�7Vjtal REASON FOR DRILLING O REPLACE EXISTING SUPPLY EW S PLY N DWELLING) ' 1 TEST /OBSERVATION Gl ADDITIONAL SUPPLY: ® DEEPEY EXISTING WELL DETAILED REASON FOR DRILLING evS 3 100 ev-0 /°,o 21$11 WELL TYPE 1OL -a—LED ®DRIVEN C]DUG 0 GRAVEL ® OTHER IS WELL SITE`SUBJECT TO FLOODING? YES f NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF.SUBDIVISION: Lot No. WATER WELL -CONTRACTOR: Name/VOXi*A�✓ Ay +ERs iNC � Address : /3,�,q6E�. Si , l�y:.vgM yAcc✓ IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: ✓ YES NO NAME OF PUBLIC WATER SUPPLY: L P l TOWN /VIL /CITY FDISTANCE TO PROPERTY FROM DTEAREST 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! (3'0) 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: &" j 2 19_//1/ - / 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 - � �fjr �. » -.w .'.I . :.: " —.: 1.,j{�i •J. 2. _��» c:•. -f'Ll :. .. I.�� /..�. ..�LI.' � �•f `j �7:.�• -. �• .I.�.��.: Od':•n -.r: F�s+`.+I C[�c. .•�T•.'. .j 56 22-32' CIO -W o, /00.00 L'E ('i, c i RNIG h 7 . i oxI 'VEJ&H'3"i 5 56 f /2 .�GACE 4r io O RCA 0 PAI7 - 61 SHOWN HEREON KNOWN .AS o r.s' !3 TO 17 (INCL.), BLOCK 61 ON KE-- PEEKSK /LL , SECT /ON F,"(FILED) t , Fi�KO55 j N� SiREc i _ 1„Ei6N ►3o►t�17 SEA ✓A�c �,s,•'osa� S "!'s��'`� (5 c 0 f i rF' i . SURVEY OF PROPERTY FOR R000L f'H KEMPERL E MARVIN O'DELL Bldg. Inspector JOHN MAHONEY Deputy Zoning Inspector TOWN OF PUTNAM VALLEY BUILDING, ZONING, AND SANITARY DEPARTMENT July 17, 1991 Mr. William Hedges Sr. Public Health Sanitarian Department of Health Division of Environmental Health Services 110 Old Route Six Center Camel, New York 10512 RE: PROPOSED WELL RUDOLPH KEMPERLE TM ... #95-2-12 AND 13 Dear Bill, PUTNAM VALLEY, N.Y. (914) 526 2377 BETTE STOCKINGER Bldg. Dept Clerk I have reviewed the above property for a proposed water well and find Or meet -8 - tt,'.e-. min umn, - requirew-en 00- -Eep-are-tion frcm. an known sewage disposal system. Yours truly, A rav�in O' Del � f- Building Inspector