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BOX 32
04163
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICE
l.., .: ; APPI,AC '1rI�N CONSTIRUCT A WATER WELL
LL -
s please print or type - - PCHD Permit # Lk) t "o
Well Location:
Street Address: Town/Village Tax G id # qr-A _ a.
-j
� , „ Map �` Block Lot(s)
Well Owner:
Name:
Address:
Use of Well:
Residential Public Supply Air /Cond/Heat Pump . Irrigation
1- primary
Business Farm Test/Monitoring Other (specify)
2- secondary
Industrial Institutional Standby
Amount of Use
Yield Sought � gpm # People Served Est. of Daily Usage _gal.
Reason for
Povlace Existing Supply Test/Observation Additional Supply
Drilling
✓ New Supply (new dwelling) Deepen Existing Well
Detailed Reason
e, A1JL= 1
for Drilling
Well Type
Drilled Driven Gravel Other
Is well site subject to flooding? .......... Yes °° No i
Is well located in a realty subdivision? ................................. ............................... Yes No
Name of subdivision Lot No.
Water Well Contractor: - Address:
Is Public Water Supply available td site? ........................................... .........:::.......... Yes No o/
Name of Public Water Supply: Town/Village
Distance to property from nearest water main:
Proposed well location & sources of contamination to be provided on separate sheet/plan.,,i
Date':
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions aof Article 10pof the,'
Putnam County Sanitary Code and 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 or- their designated
representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well' in accord'anee with the
requirements of the Putnam County Health Department. 3) Submit a Well Completion Report•on a-form.,
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and 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.
APPROVED. FOR CONSTRUCTION: This approval expires two years from the date�issued unless
construction of the well has been completed and inspected by the PCHD and is revocable for cause or may -,be
amended or modified when considered necessary by the Public Health Director. Any revision or alteration
of the approved plan requires a new permit. Well to be constructed by a w er well driller certified by Putnam
County.
Date of Issue ' 2 Permit Iss ' Offici :
Date of Expiration Title:
Permit is Non - Transferrable
ite copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
' Form WP -97
4a
- - _ SHERLITA AMLER, MD, MS, FA_ AP
- Commissioner''6 Heaitti
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Michelle Stevens
75 Hewitt St.
Lake Peekskill, New York 10537
Dear Ms. Stevens:
ROBERT J. BONDI
ROBERT MORRIS, PE
Director of Environmental Health
November 29, 2006
Re: Well Permit Application for
Stevens Property, 75 Hewitt St.
Town of Putnam Valley
This Department has approved the well permit for Well # W -57 -06 at the above referenced site.
Please be advised that if site conditions and/or site plans change and/or are revised, thereby compromising
the approved separation distances, siting approval of the well must be re- approved by this Department.
This letter shall serve as record of approval and by initiating construction of the well covered by this
approval of plans, the applicant accepts and agrees to abide by and conform to the following:
1. The well location shall be survey located and staked prior to drilling.
2. The proposed well is approved 35 feet from on -site and /or adjacent subsurface sewage treatment
system areas.
3. The well shall be installed with a minimum of, 94 feet of casing.
4:^- An,'altra, violet li ht disinfection unit shall.be installed. on the inc�min well line to the dwellin
_.. g . g g...
5. A water sample shall be cohected'and-analyzed for co"lifofii bacteria aftei`dce vweli is drilled: Tlir;
sample result is to be submitted to this Department along with the well completion report within
30 days of completion of the water well.
6. All necessary Town permits for the installation of the well are required to be issued prior to well
construction.
Should you have any questions concerning this matter, please contact this office.
Respectfully,
Michael J.
Director of
MJB:cj
cc: C. Santos, (T) Putnam Valley
Insite Engineering
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
R
7,
L E G E N D NOM these sketches are based on New York .State High Rescutive
Approx. Location Existing Well Q Statewide Digital Grtholmagery Program (2000 Pilot — Present) and digital tax
map information from Putnam County. Mass sketchas are intended to show
iubject Property Approx. Location Proposed Well . approxbnote property lines, dwellingg and septic systems for use kh assessing
possible well locatives only fiese sketches are not Mended for any other
4pprox. Location SS Direction Of Ground Slope SLOPE purpose and oro not intended to be scaled Prior to "ing my proposed
.xisting SSTS Arrow Points Downhill well, the appropriate surreys, designs, and permits must be obtained
'LAKE PEEKSKILL�er °` " / N S / T E DAM 12-07-05
WA.TE,R SYSTEM:__5J (UTD.Q EYGINE ,9/A!G SU %FYING & , , , �^ cr :_.,
.,L'@ .a. �: '".. `,: w•, .. _ _ y._ o. —�. vex C$ 108 -.:�w ,o -r_. .v-;. ;� : -
PLOT PLAN
77- LiivascaPE wcHirecruReP:�. -
3 Garrett Place • Carmel, New York 10512
75 HEWI TT ST. Phone (845) 225 -8680 . Fax (845) 225 -9717 83.74 -2 -51
wwminsfte— eng.com
DNS/ T E
ENGINEERING, SURVEYING &
LANDSCAPEARCHITEC7-URE, P.C.
December 7, 2005
Mr. Michael J. Budzinski, P.E.
Director of Engineering
Putnam County Health Department
Division of Environmental Health Services ;
4 Geneva Road
Brewster, New York 10509
RE: Town of Putnam Valley
Lake Peekskill Water System Shutdown
75 Hewitt Street A.K.A. Karpinsky
Dear Mr. Budzinski:
As we`recehtly discussed neither the Town of Putnam Valley nor the property owner ( Karpinsky)
were able to obtain an access easement over 41 the property immediately to the west of the subject
property. The purpose of this access easement was to drill a well at the rear of the subject property. As
you are aware the subject property is very small (4,000 square feet ±) and the rear of the property is not
accessible by well drilling equipment without access through the property to the west. At this time, the
proposed well location is as shown on the enclosed figure. Please advise if this is acceptable.
Should yob-'have any questions'or comments regarding this information, please feel free to contact
our office.
Very truly yours,
INSITE ENGINEERING, SURVEYING - &_LANDSCAPE ARCHITECTURE, P.C.
By.
Wiliam . Brickelmaier, III, P.E.
Senio'r.Project Engineer, Associate
WJB /amh
Enclosures
cc: Carmelo Santos, Supervisor, with enclosure
Insite File No. 04183.100
3 Garrett Place, Carmel, New York 10512 (845) 225 -9690 Fax (845) 225 -9717
120705mb.dot www.insite-eng.com
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
_ Tay+ ,.q 0p�� -�-• `'
Associate Commissioner of Health
ROBERT 1 BONDI
County Executive
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
December 14, 2005
Mr. William Brickelmaier, III, PE
Insite Engineering
3 Garrett Place
Carmel, New York 10512
Re
Dear Mr. Brickelmaier:
75 Hewitt Street (Karpinsky)
Lake Peekskill Water System Shutdown
This Department has received -and reviewed your letter of December 7, 2005 and accompanying
plan for the proposed well location at the above referenced site. The proposed well location is
acceptable and a well permit application is to be submitted to this Department by the lot owner.
Kindly advise us if there are any questions.
Respeptfully,
Michael J. Budzinski,(PE
Director of Engineering
MJB:cj � % \
cc: C. Santos, (T) Putriam 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 (843) 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
1 Geneva. Road, Brewster, New York 10509
December 14, 2005
Mr. William Brickelmaier, III, PE
Insite Engineering
3 Garrett Place
Carmel, New York 10512
Re
Dear Mr. Brickelmaier:
ROBERT J. BONDI
County Executive
75 Hewitt Street (Karpinsky)
Lake Peekskill Water System Shutdown
This Department has received and reviewed your letter of December 7, 2005 and accompanying
plan for the proposed well location at the above referenced site. The proposed well location is
acceptable and a well permit application is to be submitted to this Department by the lot owner.
Kindly advise us if there are any questions.
MJB:cj
cc:
C. Santos, (T) Putnam Valley
Respectfully;
... re -
lr
Michael J. Budzinski, (PE
Director of Engineering
I Health (845) 278 -6
Section (845) 225 -51
278 -6558 Fax (845:
n Home Care Fax
u/Preschool (845) 271
e
Ua.
&1
flU
ien
Respectfully;
... re -
lr
Michael J. Budzinski, (PE
Director of Engineering
I Health (845) 278 -6
Section (845) 225 -51
278 -6558 Fax (845:
n Home Care Fax
u/Preschool (845) 271
"` " ENG /NEER /NG, SURVEY /NG R
LANOSCAPEARCH/TECTURE, P.C.
December 7, 2005
Mr. Michael J. Budzinski, P.E.
Director of Engineering
Putnam County Health Department
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
RE: Town of Putnam Valley
Lake Peekskill Water System Shutdown
75 Hewitt Street A.K.A. Karpinsky
Dear Mr. Budzinski:
As we recently discussed neither the Town of Putnam Valley nor the property owner ( Karpinsky)
were able to obtain an access easement over 41 the property immediately to the west of the subject
property. The purpose of this access easement was to drill a well at the rear of the subject property. As
you are aware the subject property is very small (4,000 square feet ±) and the rear of the property is not
accessible by well drilling equipment without access through the property to the west. At this time, the
proposed well location is as shown on the enclosed figure. Please advise if this is acceptable.
Should you have any questions or comments regarding this information, please feel free to contact
our office.
Very truly yours,
_ .... _.� __INSITE.'ENG:INEEI?!NG, SJRVEI`iNG & LANDSCAPE ARCHITECT T URt, P.C.-
By:
Wham . Brickelmaier, III, P.E.
Senior Project Engineer, Associate
WJB /amh
Enclosures
cc: Carmelo Santos, Supervisor, with enclosure
Insite File No. 04183.100
3 Garrett Place, Carmel, New York 10512 (845) 225 -9690 Fax (845) 225 -9717
120705mb.dot www.insite- eng.com
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NOM These sketches are based an New York State H10 Resolution
LEGEND Approx. Location Existing Well A Statewide Zgltol "oftnagery Program (2000 Plot -P-1) and aWtaf tax
map Intbrrnatia" from Putnam County. These skwtd a " thtmalad to show
Subject Property Approx. Location Proposed Well A approximate property firre% dwelfingA and septic systems for use in assewhil
Possible well locallam; -1y. Mass sketch- are not Intended far my ad-
Approx Location Direction Of Ground Slope SLOPE purpose and am not intended to be scaled Prior to dr9ling OnYProPowd SST Existing SSTS Arrow Points Downhill well, the appropriate surveys, designs, and permits must be obtained
PROJEff. AQVIARM SM DAM` 12-07-05
LAKE PEEKSKILL T E Sc4M 1'�_-40'
WATER SYSTEM SHUTDOWN ENGINEERING, SURVEYING & Rmw tv-, 04183100
L4NDSCAPEARCHITECTURE, PC.
M40140, PLOT PLAN 3 Garrett Place • - Carrnel, No. Y0,* 10512 M MAP 1 83.74-2-51
Phon. (845) 225-9690 - Fax (845) 225-9717
75 HEWITT ST. 1lt__g._ I
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NOM These sketches are based an New York State H10 Resolution
LEGEND Approx. Location Existing Well A Statewide Zgltol "oftnagery Program (2000 Plot -P-1) and aWtaf tax
map Intbrrnatia" from Putnam County. These skwtd a " thtmalad to show
Subject Property Approx. Location Proposed Well A approximate property firre% dwelfingA and septic systems for use in assewhil
Possible well locallam; -1y. Mass sketch- are not Intended far my ad-
Approx Location Direction Of Ground Slope SLOPE purpose and am not intended to be scaled Prior to dr9ling OnYProPowd SST Existing SSTS Arrow Points Downhill well, the appropriate surveys, designs, and permits must be obtained
PROJEff. AQVIARM SM DAM` 12-07-05
LAKE PEEKSKILL T E Sc4M 1'�_-40'
WATER SYSTEM SHUTDOWN ENGINEERING, SURVEYING & Rmw tv-, 04183100
L4NDSCAPEARCHITECTURE, PC.
M40140, PLOT PLAN 3 Garrett Place • - Carrnel, No. Y0,* 10512 M MAP 1 83.74-2-51
Phon. (845) 225-9690 - Fax (845) 225-9717
75 HEWITT ST. 1lt__g._ I
Complaint Information
,• Log # 556- 05- 20---- Complaint Received November 09,.20( Received By, Walsh.,- Christina
i J via Telephone Time Received Assigned To Bittner, Anne
— complamanr trerson maKmg uomptainq
F Anonymous
First Last
Address
City State Zip Phone - -
— unginiaource or %,ompiamt
Origin /Source Douglas Karpinsky
Address 75 Hewitt Street
Phone - _
Location
Operation Type Complaints not associated with a eHIPS Facility
Category A condition, action, activity, place or area that is.ani
— uorrli Is Hgai
Complaint - General
Facility Address
Sub -LHU
Risk Level No risk assigned
;omplaint
Nature of Complaint Date
Complaint Water Status Needs Investigation Resolved
Description
Water situation -- no well and no permit given --
perty too small -- they are tapping into
L;.;mmunity well -- gallons of water a day.
ActionTaken
Page 1 of 1 Date Printed November 17, 2005
r,
rter Hours Log #. - - i,Unipraint
Time Received: (After hours Only) Time Ended: (After Hours Only) I Total Time: (After Hour Only)
Date Received:
Logged Bv:
How Received:
Received Bv: Referred To:
P nle
LAj
4P 2 \
Person Making Complaint:
First Name:
Street:
Town:
Origin of Complaint:
First Name:
Street:
wn:
Last Name:
State: Zip:
Phone:
r
Last Name:
L
State: ���` Zip: Phone:
r
r�
Nature of Complaint: (Briefly describe)
P nle
LAj
4P 2 \
Action Taken:
Ail
Oct,
pl.
EAt
10
040
PETER C. ALEXANDERSON
County Executive
i
• . e . +w �,�. .:. �; a,.' c • c .. ..arc• �. . t : i'- ��> : -� .. .
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
110 Old Route Six Center, Carmel, New York 10512
(914) 225 -0310
October 21, 1987
Laslo Haldak
180 Hewitt Street
Lake Peekskill, New York 10537
Dear Mr. Haldak:
JOHN SIMMONS. M.D.
Deputy Commissioner
JOHN KARELL, Jr., P.E.
Director
RE: Proposed Well Construction
180 Hewitt Street
(T) Putnam Valley
You are hereby advised that your request for a variance from
provision of the required 100 foot separation distance between
your proposed well and the proposed sewage disposal system on
your property has been considered by the Board of Health on
October 19, 1987 and denied.
RJ :pt
cc:Building Inspector
RJ
JK
File✓
ery truly y urs,
Ray rdof n s
Pre
Boealth
DAVID D. BRUEN
County Executive
laslo Heldak
180 Hewitt Street
Putnam Valley, NY 10579
Dear Mr. Heldak:
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
August 5, 1986
RE: Proposed Well Construction
180 Hewitt Street
(T) Putnam Valley
JOHN SIMMONS. MO
D*Puty Commissioner
Review of an application to construct a well for potable water supply purposes
to serve the above property has been canpleted.
Review indicates as follows:
1. The lot is presently supplied by the Lake Peekskill Water Works with summer
water.
2. The lot area is approximately 4,000 square feet or 1 /10 acre.
3. The proposed well is located approximately 45 feet fran the existing sewage
disposal system on your lot and 85 to 90 feet away frcan two adjacent sewage
w- ._ disposal. systeJms - -
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 construct a well on this property is hereby DENIED.
y ours,
hn rell, Jr., P.E.
Director Environmental Health Services
JK:mk
cc: Building Inspector
J & E Associates
JK
File
P
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
p?FL- CATI0:1 FOR PUBLIC ACCESS TO R=COFOS
TO. RECORDS ACCESS
& &6T&
Na -me Of Ace-cv JOSEPH L_ FSLOSO, JR_, PUBLIC
I`i= TI
ION OFFICE'.
Address
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DAVID D. BRUEN
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
August 5, 1986
Laslo Heldak
180 Hewitt Street
Putnam Valley, NY 10579
RE: Proposed Well Construction
180 Hewitt Street
(T) Putnam Valley
Dear Mr. Heldak:
JOHN SIMMONS, M.D.
Deputy Commissioner
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 Works with summer
water.
2. The lot area is approximately 4,000 square feet or 1 /10 acre.
3. The proposed well is located approximately 45 feet from the existing sewage
._ .disposal. system on your lot--and 85 90 ..feet_away. from`_two adjacent sewage
d5posa'1 "5yjtemso �.
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 construct a well on this property is hereby DENIED.
y ours,
thZnrell, Jr., P.E.
Director Environmental Health Services
JK:mk
cc: Building Inspector
J & E Associates
JK
File
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
DEPARTMENT OF HEALTH
z Division Of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225-3641
APPLICATION TO CONSTRUCT A WATER WELL
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Aggz*tSK /GL SECT. 4. LOT NO.:
WATER WELL CONTRACTOR: Name //p 4 14Wi uon� Address :
.v,
IS PUBLIC WATER SUPPLY 'AVAILABLL"'TO SITE: d,"-YES NO
NAME OF PUBLIC -WATER SUPPLX - �UTti�9�t AGGGyy TOWN /V /C P�TN
DISTANCE TO- PROPERTY FROM NEAREST 11ATER:MAIN �
LOCATION SKETCH & SOURCES OF CONTAMINATION.
(dat ) (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
Permit .Issuing Official
Permit is Non- Transferrable
A
STREEI ADDRESS.
I WN /VILLAG ici Y W ViU NUMBER.
NELL LOCATION
W 7.7_
mss' /� :7
WELL OWNER
NAME. •
ADDRESS:
0 hy�'tl T %s7;'
IVATC
❑PUBLIC
USE OF WELL
OJ RESIDENTIAL
❑ PUBLIC SUPPLY ❑ AIR /COND. /HEAT PUMP
❑ ABANDONED
1 - primary
❑ BUSINESS
O _FARM ❑ TEST /OBSERVATION
❑ OTHER (specify)
2 - secondary
❑ INDUSTRIAL
❑ INSTITUTIONAL Q) STAND -BY
o❑ NIA72�`f wo s Ski
AMOUNT OF USE
YIELD SOUGHT
-� gpm. /N0. PEOPLE SERVED °� / EST.
OF DAILY USAGE, gal.
REASON FOR
❑ NEW SUPPLY
PROVIDE ADDITIONAL SUPPLY
O TEST /OBSERVATION
DRILLING
❑ gEPLACE EXISTING SUPPLY O DEEPEN EXISTING WELL
2 DRILLED
� DRIVEN � DUG GRAVEL OTHER
WELL TYPE
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Aggz*tSK /GL SECT. 4. LOT NO.:
WATER WELL CONTRACTOR: Name //p 4 14Wi uon� Address :
.v,
IS PUBLIC WATER SUPPLY 'AVAILABLL"'TO SITE: d,"-YES NO
NAME OF PUBLIC -WATER SUPPLX - �UTti�9�t AGGGyy TOWN /V /C P�TN
DISTANCE TO- PROPERTY FROM NEAREST 11ATER:MAIN �
LOCATION SKETCH & SOURCES OF CONTAMINATION.
(dat ) (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
Permit .Issuing Official
Permit is Non- Transferrable
A
m
J & E ASSOCIATES
1065 Spillway Road
Shrub Oak, New York 10588
(914) 245 -6320
Pravin Jain, P.E.
Civil Engineer
Vincent Ettari,
Civil Engineer
l
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
Mr. Laslo Haldak October 13, 1987
180 Hewitt Street
Lake Peekskill, New York 10537
RE: Variance
Haldak
180 Hewitt Street
Putnam Valley (T)
Dear Mr. Haldak:
J.ki(
JOHN SIMMONS, M.D.
Deputy Commissioner
JOHN KARELL. Jr., P.E.
Director
The matter of your request for a variance has been placed on
the agenda for the October 19, 1987 Board of Health meeting
which is scheduled to be held in the Conference Room in our
offices at Environmental Health Services, Boces Building 3,
Carmel, New York at 7:30 P.M.
JK:pt
cc:Ray Jones
JK
File
V ry trulyours, /
/John Karell, Jr., P.E.
Environmental Health
Services
-11, -7� " _�.; . I - 11 f -1 V I
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v � v
DAVID D. BRUEN
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
September 2, 1986
Laslo Heldak
180 Hewitt Street
Putnam Valley, New York 10579
Dear Mr. Heldak:
JOHN SIMMONS. M.D.
Deputy Commissioner
Re: Proposed Well Construction
180 Hewitt Street
(T) Putnam Valley
Please be advised that the permission of adjacent property
owners does not mitigate the inadequate well to sewage system
separate distances and cannot be considered by the Department
granting approval.
The denial.is appropriate and will stand.
V ry rul yours,
o n Ka ell, Jr., E.
irector,
JK:pt ` Environmental Health Department
cc :JK
File
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225 -3641
T. t
DAVID D. BRUEN
County Executive
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
August 5, 1986
Laslo Heldak
180 Hewitt Street
Putnam Valley, NY 10579
RE: Proposed Well Construction
180 Hewitt Street
(T) Putnam Valley
JOHN SIMMONS. M.D.
Deputy Commissioner
Dear Mr. Heldak:
Review of an application to construct a well for potable water supply purposes
to serve the above property has been canpleted.
Review indicates as follows:
1. The lot is presently supplied by the Lake Peekskill Water Works with summer
water.
2. The lot area is approximately 4,000 square feet or 1 /10 acre.
3. The proposed well is located approximately 45 feet fran the existing sewage
d� poal- system on yo�zr. lot and to -
85 90 feet away._frc�,tr .-adjacent sewage: T,
_... ._ ..- •disposal system's.� - .- ..._ . _ ... .-
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 construct a well on this property is hereby DENIED.
Z rely ours,
l, Jr., P.E.
Director Environmental Health Services
JK:mk
cc: Building Inspector
J & E Associates
JK
File
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914) 225-3641
LASLOW HELDAK
180 Hewitt Street.
Putnam Valley .. 1'1 5'T,�
August 21, 1986
John Karell Jr., P.E.
Putnam Department of Environmental Health
Two County Center
Carmel, NY 10512
Dear Mr. Karell:
On July 24, 1986, I submitted an app.l.ication to the
Department of Environmental Health to install a well on my
property. An accompanying drawing showed the proposed well 15 feet
off my rear and side property lines and 45 feet from my septic.
That application was rejected since I could not maintain 100 feet
between the proposed well and existing septic system
Since then, I.have conferred with my attorney and attached
are letters from my neighbors granting me permission to come up to
the property lines with my well., They will grant easements if
necessary. I also excavated the septic pit to determine its exact
location, which is shown on the accompanying survey. I am,
therefore, proposing to put the well approximately three feet from
my rear and side property lines, as shown on the drawing, which
will -keep the wel1 seventy .feet .from my own septi c- ...system,.. and.
about 80 feet from all surrounding septic systems.'
Please note that my neighbor to the. left, looking'at my
property from the street, was allowed to drill a well.about 50
feet from his septic system and 60 feet from my own system.
Moreover, I should note that my house is only a 2 bedroom house,
and therefore, I feel that the variances needed to place this well
are not excessive, and certainly creates no worse a situation than
has been allowed with my neighbor's drilling their own separate
well. Moreover, I would like to add that I am a senior citizen and
on a fixed income, making it impossible for me to seek housing
elsewhere.
Please send your reply directly to me since J & E Associates
has been discharged from my service.
Sincerely yours,
Laslow Heldak
L
DEPARTMENT OF HEALTH
Division Of Environmental HJyh Services
TWO COUNTY CENTER - CARMEL, N.Y.. 10512 (914) 225 -3641
_.�, <.._..r...,... , _., ..... < .. ,. - APPLICATION` TO' R WELL Up
WELL TYPE 'DRILLED F_� DRIVEN E] DUG E] GRAVEL F-1 OTHER
i
IS WELL SITE SUBJECT TO FLOODING? _ YES t,/NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
i L. C� _ � � ==i !?1z_ LOT NO - - i 7 z
WATER WELL CONTRACTOR: Name X7!�,yece e�,,,Address :
7,9 �-
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: -Y-_� S NO
NAME OF PUHLIC WATER SUPPLY - 14!i TOWNI /V /C
. � •sir: �� /�� srT7� � ; i %/�
r rti'vl� KS
DISTANCE TO PROPERTY FROM NEAREST WATER.MAIN
LOCATION SKETCH & SOURCES OF CONTAMINATION . 6- T.
(date) " / 1 (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
2. Disinfect the
of the Putnam
permit.
3. Submit a Well
the Putnam Col
Date of Issue:
until the water is clear.
well in accordance with the requirements
County Health Department attached to this
Completion Report on a form provided by
anty Health Department.
Permit : is.Non- Transferrable-
19
Permit Issuing Official
c A 5 WWNIVILLAGEICITY
IAX GRW NUMBER.
WELL LOCATION
JET z- i
d T
WELL OWNER
NAME. •
`.� Z
AGGRESS:
� �
�
� ���
IV'
� �
Pu3CS
., ,,��
s
USE OF WELL
D"RESIDENTIAL C3 PUBLIC SUPPLY
❑ AIR /COND. /HEAT PUMP
❑ ABANDOPlED
1 - primary
❑ BUSINESS ❑ FARM
❑ TEST /OBSERVATION
❑ OTHER (specify)
2 - secondary
❑ INDUSTRIAL ❑ INSTITUTIONAL 0. STAND_-BY
❑
MOUNT OF USE
YIELD SOUGHT gpm. /N0.
PEOPLE SERVED EST USAGE e. se. rc
/. OF DAILY 1Loc3 oaf.M
REASON FOR
❑ NEW SUPPLY
19-PROVIDE ADDITIONAL SUPPLY
❑ TEST /OBSERVATION
GRILLING
❑ $EPLAC.E- EXISTING SUPPLY
❑ DEEPEN EXISTING WELL
WELL TYPE 'DRILLED F_� DRIVEN E] DUG E] GRAVEL F-1 OTHER
i
IS WELL SITE SUBJECT TO FLOODING? _ YES t,/NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
i L. C� _ � � ==i !?1z_ LOT NO - - i 7 z
WATER WELL CONTRACTOR: Name X7!�,yece e�,,,Address :
7,9 �-
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: -Y-_� S NO
NAME OF PUHLIC WATER SUPPLY - 14!i TOWNI /V /C
. � •sir: �� /�� srT7� � ; i %/�
r rti'vl� KS
DISTANCE TO PROPERTY FROM NEAREST WATER.MAIN
LOCATION SKETCH & SOURCES OF CONTAMINATION . 6- T.
(date) " / 1 (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
2. Disinfect the
of the Putnam
permit.
3. Submit a Well
the Putnam Col
Date of Issue:
until the water is clear.
well in accordance with the requirements
County Health Department attached to this
Completion Report on a form provided by
anty Health Department.
Permit : is.Non- Transferrable-
19
Permit Issuing Official
SYLVIA BERNSTEIN
Point Drive No.
Lake Peekskillo NY 10537
(914) 52.8-8786
August 21, 1986
Mr. Laslow Heldak
180 Hewitt Street
Putnam Valley, NY 10579
Dear Mr.Heldak:
I am writing this letter to you to grant you permission to
come closer than ten feet to property line, which separates
our properties, with your proposed well. Should it be necessary, I
am willing to grant you a ten foot easement on my property, so as
to enable you to drill a well on your property.
Sincere y yours,
1.- 4
c-rnst.cin
MS. EILEEN S. FREDRICKSON
Box 445
Lake .Peekskill.,'. NY 10537
(914)..528 -3414
August 21, 1986
Mr. Laslow Heldak
180 Hewitt Street
Putnam.Valley, NY 10579
Dear Mr.Heldak:
I am writing this letter to you to grant you permission to
come closer than ten feet to the property line, which separates
our properties, with your proposed we Should it be necessary, I
am willing to grant you a ten foot easement on my property, so as
to enable you to drill a well on your property.
Sincerely yours,
Eileen Fredrickson
PIT NAM COUNTY DEPARTMENT OF HEAL'T'H
DIVISION OF ENVIRONMENTAL HEALTH SERVICE �
APPLICA'I'IiON T O CONS'IFRUCT A WA r ElIl vvtLL,
please print or type PCHD Permit #
Well Location:
Street Address: Town/Village Tax Grid #; r
- ;1 , ` �{, , Map � � Block Lot(s)
Well Owner:
Name:
N U\--Nc\c �
Address:
`15 b-v,
Use of Well:
Residential Public Supply Air /Cond/Heat Pump Irrigation.
I- primary
Business Farm Test/Monitoring Other (specify)
2- secondary
Industrial Institutional Standby
Amount of Use
Yield Sought �� gpm # People Served Est. of Daily Usage gal.
Reason for
lace Existing Supply Test/Observation Additional Supply
Drilling
New Supply (new dwelling) Deepen Existing Well
Detailed Reason
for Drilling
Well 'Type
Drilled Driven Gravel '` Other
Is well site subject to flooding? ................................................. ............................... Yes No
Is well located in a realty subdivision? ....................... ............................... ........... Yes No
Name of subdivision Lot No.
Water Well Contractor:` : f--,.7 j _ Address:
.......... Yes No
Is Public Water Supply available td site? ' _ /�
Name of Public Water Supply: Town/Village _
Distance to property from nearest water main: - -
Proposed well location & sources of contamination to be provided on separate sheet/plan.
Date: Applicant Signatur( /,a
�Jv1= — 4 FT M,NIMux10 F- cA-S,ti cl v ui
91 ZSN
PERMIT TO CONSTRUCT A WATER WELL
,
This permit to construct one water well as set forth above, is granted under provisions" of °Article. l6'J of the
Putnam County Sanitary Code and 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 or their designated
representative 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. 3) Submit a Well Completion Report on a form
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and 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.
APPROVED FOIE CONSTRUCTION: This approval expires two years from the date issued unless
construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be
amended or modified when considered. necessary by the Public Health Director. Any revision or alteration
of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam
County. /
Date of Issue _ Permit Iss ' Offici
Date of Expiration Title:
Permit is lion - Transferrable
,ite copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
V ^, WD-01
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�.�G The premises hereon beinq Lots 179 B 180
<
3
ition I
House
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of Bock N° 2 , as shown on mop enfit/ed
— -
—
—
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—
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"Lake Peekskill, Section A "' said t7tap filed
—•-•�
in the Putnam County Clerk's Office on
Li
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Conc.
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Moy 28, 1929 as Map N9 185.
LOT 180
Conc.
Walk
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Certified only to .' LASLO HELDAK
DUE WEST chain
[fn* Fence
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LAND RESEARCHERS LTD.
Q
LOT 181
J
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j
SURVEY OF PROPERTY
— S /TUA°TE_ IN THE —
TOWN �V N VALLEY
Only copies from the original of this survey with on origiauf of the
Cerlificolians hereon signify that this survey was preporedin o�'cordance
I P� C
land surveyors inked seal or his embossed seal shall be considered to
with the existing Code of Practice for Land Surveys adopted by the New
A& valid true copies.
York State Associo/ian of Professionul Land Surveyors, /be.. `. Said
"
ROBERT E. BAXTER B ASSOC.
certifications 5/5&// run only to the person for whom the sucJey is
PUT/VA,�9 COUNTY
Of NEW
Land SLrVey0r5 and P/onners Q�� W ra
prepared, and on his behalf to the title company, go
S� �gT E• S, P�
P. O. Box 29B R. D. /, Box 277 - C oe '4•
and lending institution listed hereon, anO/a the assignees at !4e lending
NEW Y ®RK -
f�
Mehopac, N. Y Hopewell ✓ct, NY.
institution. Certif /colfons ore not transferab /e to addittbno inSldetl /ens
1
628 -2800 221 -1192'
or to subsequent owners,
u ,
SCALE••/ = /5 DATE JUNE /5, 1985 .
Unauthorized alteration or addition to a survey map beariag a 11cerued
UPDATED FE8RUARY 20,1986
49434
land surveyors sea/ /s o via /atian of Seel/on 7209, SuA- Oi vision 7_.
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