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HomeMy WebLinkAbout4271DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.82 -2 -45 BOX 32 04271 !�`o . ' f ;1 '� .` lee f W � I L ' T . ' is .� � 1 11110 e-.f 04271 4 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 # t/o -4,��/ WELL LOCATION Street Address s S f; Town/Village/City Tax Grid Number 491« P6,6',rs «, sEF h WELL OWNER Name Mailing Address ®Private Mce4R(Z i1 7OS�P�( .S'f CAKE .%%t' 'KIZL O Public USE. OF WELL 1 - primary 2 It secondary .1 RESIDENTIAL 0 BUSINESS. 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP O ABANDONED O FARM O TEST /OBSERVATION O OTHER (specify, O INSTITUTIONAL O STAND -BY O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED 2 /EST. OF DAILY USAGE .SO gal 13 REPLACE EXISTING SUPPLY O TEST/ OBSERVATION Q ADDITIONAL SUPPLY O NEW SUPPLY NEW DWEL ING !O DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR ..DRILLING 0 //l 14 191qCx4e14 S 404 4 P. 5 sue-. WELL TYPE .DRILLED QDRIVEN []DUG 0GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. V WATER WELL CONTRACTOR: Name AIOAiAM J 9AJI)6e-e�'J Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY _... DISTANCE' `PO -PROPERTY FROM NEAREST--WATER= LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ❑ON SEPARATE SHEET I ((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. During all well drilling operations, the applicant shall take approfriate action. to assure that any and all water or waste products from such well drilling op.erations.be•contained on this property and in such a manner as not to, degrade or otherwise.'contaminate surface or- groundwater. Date of Issue: 19 Date of Expiration 19 Permit Issuing Official °ermit is Non - Transferrable White copy: HD.File Pink copy: Owner X89 Yellow copy: Bldg. Insp. Orange copy: Well Driller i -. , -- x _ _ _ _, 4r7 7:.. DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225 -0310 Joseph McCarren 1 Mathis Street Lake Peekskill, NY 10537 Dear Mr. McCarren: "X JOHN KAHELL Jr., P.E., M.S. Public Health Director October 23, 1991 Re: Well Construction Permit *W -63 -91 McCarren, 1 Mathis St. (T) Putnam Valley TM #106 -1 -101 I have received and completed the review of the application to construct a well on the above mentioned parcel. The application , as submitted, is denied for the following reasons. 1. The proposed well is located within 50 feet of the sewage disposal _ #�olot-- �° 9r5r,.. 9f ca��t� =�9�Ic:. >_:. ; <:,;:_.._..... -,. A minimum of 100 feet is required. If you have any questions concerning this matter, please contact me at your convenience. Very truly yours, William He ges Sr. Public Health Sanitarian WH /jp Bldg. Inspector JOHN MAHONEY TOWN OF PUTNAM VALLEY Deputy Zoning Inspector BUILDING, ZONING, AND SANITARY DEPARTMENT September 16, 1991 Putnam County Dept. of Health 110 bid Route Six Center Carmel, N.Y. 10512 Att: William Hedges Re: Dear Bill: Joseph McCarren 1 mathes St. - LP TM#106-1-10 Per your request, I have reviewed the above noted proposal to construct a water well for backup supply and observed the following: The proposed well site avrars to be located (see survey) within fifty (50 feet of an existing. SSDS on property of the Smith gamily on Lots 95, 96 and 97 as shown- on Subdivision Map of-Ljke,.P9-ekskill JOWN-HALL.. -'PUTNA ''VAIILE N-Y- (914) 526 2377. BETTE STOCKINGER Bldg. Dept. Cie* Yours truly, MARVIN O'DELL Building .& & �oning Inspector MO'D:es cc: Survey TM #106 Application 146-1 DEPARTMENT OF HEALTH Division of Environmental Health Services :1I p��OI.R...ROUTF SI7� .ENTER,: CARMEI., N >. Y;- .•;Q Y( °1!i): R225 0310- , , . _ _ APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT WELL LOCATION Street Address ! ANA % /c'S Sf . Town Village City Tax Grid Number 4A /CF WELL OWNER Name Mailing Address ®Private mclftva" 7osepw ! 1'�rvis: Sfi 44ffC O Public USE OF WELL 1 - primary 2 L/ secondary ® RESIDENTIAL. O BUSINESS 0 INDUSTRIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP ❑ ABANDONED . O FARM O TEST /OBSERVATION ❑ OTHER (specify O INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE SO gal ❑ REPLACE EXISTING SUPPLY ❑ TEST /OBSERVATION M ADDITIONAL SUPPLY ❑ NEW SUPPLY NEW DWELLING C] DEEPEN EXISTING WELL w w'&' 4 _ 4c<,_1,4 SvCr�LV REASON FOR DRILLING DETAILED REASON FOR DRILLING /' O -e X c X a 3 c% 5 s�-•- 7`4 ­y "e -epr, WELL TYPE ❑DRILLED DRIVEN aDUG ®GRAVEL C] OTHER IS WELL SITE SUBJECT TO FLOODING? YES ✓ NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot No. L/ WATER WELL CONTRACTOR: Name IV(IA4141 PAJi)4 ,F Z rlJ 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: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED ) 7- 23� �/ ❑ON SEPARATE SHEET �, , , /�1,�; (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. Dis -nfect 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 Departmen 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• 19 Date of Expiration 19 Permit Issuing Official Permit is Nun - Transferrable White copy: HD.File Pink copy: Owner �89 Yellow copy: Bldg. Insp. Orange copy: Well Drill/ a � 2 r. .xa ,r. _.. �m'^�;....:�, ,.�• - �=•�:' � �. .at '. =;x., '•2. .- .•\�\ -. �� _. se. rm�. -.cx ice':', v.':.rm ,��- f'i^.: •..'�...:.,,•. :.: i.: 4..•.. '.+e4 � =�ti;�� ..p:'k�i ^�r/ -[�1• e� ti ^° a 1 ? 53 54 1 � y E O I 0 56 NO N \ 0 \ 01 9 ' ,a�1 0 f`�c° •fop \\ tp CL / O 9c fie' J/ olrod �r 98 1 f ti G 1 i4�THE I S Mocodo/O1 1,: 407- 'F act toneA f 1 //I 510rr Fr. Dwfll . Fey q` %p�n 1�nSef- N/Oo 2f WO// 0. "�_ ! v.: 109 100, It It of ` /(✓ / `1 1,`• 3� } ,`. `, )'`� •241 `It ', ,t \ 'i "8 _ - _ l " -2� -• \ .' _ ' " - / f, �4c-3 t_��i �� / •123` ,'C''1 s 11't , ` ` , _ / \\\ i /�'��. •ri��n - j stpE %/ �; , , 1 „1 1 , • 1 1 1 \MF, ------------------- %'-- - to 20 •+ 4 "Y - - ", to ;" \` _ _ 2 I y r;-;,` 104 /': " - -IT " _' �. L. ' ; - / l j „- ;O Q 21 51 loll `\ \ \�, \" may' • i ♦// ''S ,'n l9F�r �� IS.I .. -' "s ' 2 \ \ \`` / /� / '_1 „ �\.'' iv•, � �'� , ;�� ,fit: \ -` ` "N J `` /�/ _. �/ / ,S. / - -'f-----° s : \�\ \•s —_ = �� /S7aEEty l �-,M \ .. / �:`'' ``9� ,� �// _���, 107 I�' t I r4 i i t � t � 10 -•� / rE 105 rw i3 '. t. :' 1 ii 102 113 109 T 3 % 109 , \ _ Iii +• pats/ � ` L 103 % 3 A 25' ---------3 --- ------------ 20 'to --------- -- -- A-1 104 �gl 3 N, w 7 7 all 107 "12 105 .4. p 105 644 S O"Ly REVISIONS SPEML DISTRICT)KCRM4110.1) PRELIMINARY 106 TOV.N OF PUTNAM VALLEY