HomeMy WebLinkAbout4275DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
83.82 -2 -53
BOX 32
Lgil I"
IT
i
YL 'i..*.
:I .I
04275
PV Lb '80 b
V/,//
PUTNAM COUNTY HEALTH DEPARTMENT
.DIVISION OF ENVIRONMENTAL HEALTH SERVICES
_ " = sw.•%�r.:�== elc "�.'o.. evr 'a: 'r'�'.�• -..r " , ., � ,e .: �.., ..._� -fir` .. .:...::�•s� == ..y..:
Id =c , 41—
i
PERMIT At
U V--,RepWr Repair Permit issued in last 5 years of in Watershed
❑ within Boyd's Comers, W. Branch or Croton Falls Res. Delegated
11 epair within 200 ft. of a watercourse or DEC - mapped wetiand t ❑ Joint Review
SITE LOCATION
OWNER'S NAME
MAILING ADDRESS °
APPLICANTrc�IC
TOWN kIkEfgff 'TM # 1r,
PHONE # ft 14 LE
s
L
Name & Relationship (i.e., owner, tenant, contractor)
DATE 4f�'— FACILITY TYPE _ 1AOQS-E-- PCHD COMPLAINT #
PROPOSED INSTALLER CAS 1114"s PHONE #
ADDRESS �(� GISTRATION /LICENSE #
Proposal (include a separate sketch locating the house, property lines, all adjacent wells within 200
feet of repair and the location of existing and proposed syst #m)
NOTE: The Department may require submittal of proposal from licensed professional depending on the
nature and ent of the repair.
r�
41'64-11 fA6, -34.0 D74-, A✓iA A,Gw n)) Ae 01
I, as owner,agree to the conditions stated on this form
SIGNATURE TITLE DATE
(owner)
I, the septic instalee agree to cold ly w W I the conditions of this permit for the septic system repair
_ ._._. _.,.., .r -. •Si�'ahli�i'- _(� _T'ITL'E'._....:_ .,: _ _-
Li%4'iE
pnstalle
Pr000sal approved with the'followina conditions
1. I�rocurement of any Town Permit, if applicable.
2. Submission of as built repair sketch by the septic system installer within 30 days of the repair, in duplicate showing:
a. Owner's name, Site Street Name, Town and Tax Map number
b. Location of installed components tied to two fixed points
c. System description (e.g., 1250 gal. Concrete septic tank, etc.)
d. Installers' name and phone number
3. System repair to be performed in accordance with the above proposal and conditions
4. The proposed SSTS repair is considered a best fit design and there is no guarantee to the duration at which the
completed SSTS repair will function.
5. No completed work is to be backfilled until authorization to do so has been obtained from the Department.
INTERNAL USE ONLY
Proposal Approved Proposal Denied ❑
S-17 f /7
Ins or's nature & Title Date Ex0ralfon Date
,Repair proposal is in compliance with applicable codes Yes ❑ No ❑
COPIES: PCHD; Owner; Installer
PC -RP 99ML Rev. 2/07
14
-ka
c
r
x uuxaw %-,,vuj-tLy jupau-nient of -tiealm
Complaint Form'
After Hours Log # Complaint 17o
-7ffie—M6&�fv6d." (aft hours only)
Time Ended: (after hours only)
LOtal Time: (af ker hours
Received 13 . y
Referred TO
t
Date Rlqceived
Lo
-----I BY
How Reegived
Received 13 . y
Referred TO
Person Making Complaint:
First Name: Last Name: , F,
Street:*
City: State: Zip:
Contact Phone:
Email:
Origin of Complaint:
First Name: Last Name:
Street:
City: I10Z,1--,14 State: zip:
Phone: Email:
fiction Taken:
:11/24/14
Lisa Seymour
:f[6 7
Sent Friday, July 24, 2015 3:05 PM
To: Rich Quaglietta (rquaglietta@putnamvalley.com)
Cc: Marianne Burdick
Subject: Septic repairs without permit 26 Harper St.
Hi Rich,
Just a reminder if any Health Department staff is not in the office when you call and there is something important like a
repair without a permit- please call the receptionist right away. This way a supervisor will be informed and someone can
be assigned to respond right away if needed. You can dial extension "0" from the end of a voice mail message to get the
receptionist. Please also share with Doreen.
FYI- 26 Harper St. may have to remove their septic system if went closer to their own well. Dan Reis said he was going to
send them a letter asking them to get a permit. He said soil tests are needed;* system will need to dug up.
Lisa Seymour
Public Health Sanitarian 11
Putnam County Dept. of Health
I Geneva Road
M---Brewster-NY4-0509----
—E--m- iff-avd'"die'�ss: ii—sa�se-v--m,o-u-rc—@",p-ut-n,am—c-o*u-n-t-v-n-y.,go-v*--
Tel: 845-808-1390 extension 43162
Fax: 845-278-7921
O
Putnam County Department of Health
Division of Environmental Health Services
SSTS Repair — Final Site Inspection
Date: �� ��I Inspected -by: Dwme 13xis Installer: orv�Cow�cr
Street Location 6 N._St. _ - • - . Owner:.
.,� ..;. xis a+iy. • t'r4w:,,, y ° ;���� " �: Repair Permit # r — 113 e TM #
1 of System: Conventional O Alternate O Comments:
2. tic lank I Yes INojN/Aj
Comments
a Septic tank size —1,000 ... 1,250 ... other .....
Al `
b. Septic tank installed level ......................
c. 10' minimum from foundation ..................
.
J .
d. DistributioR Box
i. All outlets at same elevation (water tested) ...
ii. Protected below frost.............................
iii. Minimum 2 ft. Original soil between box &
trenches
e. junition Box —Vro er set .............................
i. Stem �ompletely opened for inspection
ii. Length required Length installed
iii. Pipe slope checked ... ...............................
iv. Installed according to plan .....................
G
v. 10 & from property line — 20 ft — foundations ...
vi. Size of gravel % -1 '/: " diameter clean .........
JJ
-h %...
vii. Depth of gravel in trench 12" minimum ...........
viii. Ends capped
g. Pump or Dosed Systems
3. Lew eftstemArea.
a. SSTS Area located as per approved phms
b. Fill section —
c. Distance from water course /wetlands
4. Overall Workmanship
a. Boxes properly grouted and installed correctly ...........
b. All pipes flush with inside of box .........................
c. Backfill material contains stones <4" diameter .........
d. Curtain drain & standpipes installed according to plan
e. Curtain drain outfall protected & dir to exist watercourse
f. Footing drains discharge away. from SSTS area ......:..
g. Erosion control provided ............................
Additional Comments:
RFSI Rev - 011312
��2r
,�} ,f6 a �'�. ,''_.•..��,��. it \ .,,y���' �"�... " 9�',� "&1P ,lti {� qtr � �f'v. �.: �� ,,i�.
ak e "Mm s~" raw AVA y �xp
4 /
rP�
e § � w, �� i � ��.
r
r,
t
M$ k
b
J
,
OR
�!- ,� �i . �+x „• 'fro : �� � „ ,a � a.' 4�a � �� � {x, �'t ?"�,�� k ` �a*� �;
`mo
> > �t to +.a e.. �. ;; �c �+7 ����'`� r�' %� �a�' 4 a'� �• �v � �4 @ F#3 �'
+ '`"- ti i } -}.• 7� t�ey:'L�n F� �,d {R �t"$� ,1,^� ?�� �',ta1� `P '� r�4``
?K
bFv"'*s "•` d f4`mL`. - .�.p�.
i v,Y 2 �a�'a�, �
3xh�:�,a4�a�5
P'a�'x Kdf 3aq. Al
• � �:. -,�. �i:, .. 4 +� r a��' s '�aL a x�, �`T�� it � H, 'w,a^`��r i�.`+ i'� °d � a `^ ` °a K t � } !'.. �4
�`, � c��a. 5 ^ice " y v-'• r �, ,
it .� .� �• s ti' <.
• Ft d _ {t:.t dry ` an�,� �S -r„tn � <
�!T
'
l-7- ti t
�IJ
A
iiiT �'
�`�1� Y'•� "ray R`
>4'S^�
`�
�3 T�xy�a• ..
��Nt+��
}
A
T�
4.
ALLEN BEALS, M.D., J.D.
- ..�rCommissioner of Health
ROBERT MORRIS, P.E., MPH
Director of Environmental Health
MARYELLEN ODELL
County Executive
yr"-'- i «,..aa.�np'f- .�,:;+�+aa'at.iz. oc.:.eW.: �rM'•= �o'iv.R.v;.v. -. n a:'�i+�+ a'c-= ....:= cc...
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York 10509
Phone. #. (845).808 -1390 Fax #..(845) 278 -7921 -
CERTIFIED RETURN RECEIPT REOUESTED
PLEASE REFER CORRESPONDENCE TO:
TO: Francis Williams NAME: Daniel Reis
26 Harper Street TITLE: Environmental Health Aide
Lake Peekskill, NY 10537 PHONE: (845) 808 -1390 ext. 43130
DATE: July 30, 2015
Come -1.y�, -15- Iqo(A)
OFFICIAL NOTICE OF NON - COMPLIANCE
YOU ARE HEREBY NOTIFIED that non - compliance with Article III, Section 2A of the Putnam
County Sanitary Code as stated below:
"... No person shall undertake to construct, or allow to be constructed, any SSTS
modification or repair to a SSTS without first having obtained the written approval for
such system from the Director /Commissioner."
Specifically: Homeowner modified SSTS at 26 Harper Street, (T) Putnam Valley, without approval from
the Director /Commissioner on July 20, 2015.
—. C.. ...-- _ 'Y r -T-r— — --r —6M ... �. --_a. v.?C�„_ ••'°'S
"the violationjs)'is7are not corrected by Augusf 30, 2015 an O�f>ricial Notice of Iearirig wil�be issued.
This will make you liable for additional penalties provided by law, including prosecution on a charge of
committing a violation punishable by a fine or imprisonment, or both such fine and imprisonment, as
prescribed by law, in addition to such other action as may be prescribed. A re- inspection will be made.
It is sincerely hoped that the above - mentioned further action will be necessary and that you will cooperate
by securing the correction of this condition. If you believe the above notification is incorrect, please
notify this office immediately.
For the Commissioner of Health
Very truly yours,
Allen Beals, M.D., J.D.
Commissioner of Health
By:
OZniel eis
Environmental Health Aide
DR: cm1
•it
\ - !O!
Pt
ro
i
T va ilcJ t i �VJ.?.1 al
ILI
\41
99
i r
of
Jv of,
( fi oll \
ru
OD
�t s
f �
. 52 sit •�., �`�
( { .',p
�ti°• P/O 9.1.26.2'28 o,,
83.75
m NARY MAP
L �. e
m E SCALE � 5� r
Z TOWN QP PUTN�:: M°
0 VALLEY 7
° 91.27 o �:
P
no
UTNAM COUNTY,
"NEW YORK QA1E OF AERIAL MaToQUW( 4•+o•er IMli of +,,�� ?,:�.1�•e4
' is
N 2(r, (J*P f d1 ST- 7 MY STATE FLAK OMINATES NX . - -IN FEET
�t 4'�`�`
rum"*
Daniel Reis
z • r`s:'a :++:�- a'ac: vc`vs e ='., i� �° ' .oe o ya i+.iFs= s=�: 'rte "7 gin.. a4, re "v
From: Francis William`s <fwilliams0lgmail.com>
Sent: Friday, August 07, 2015 11:19 AM
To: Daniel Reis
Subject: RE: Websites to look for pits
Do you want me to take pictures before.I put it in the ground?
On Aug 7, 2015 11:12 AM, 'Daniel Reis" < Daniel .Reis @putnamcount�ny.gov> wrote:
Yes that it correct, gravel base and around the sides. When you get it send me pictures.
From: Francis Williams [ mailto :fwilliams0721C@gmaii.coml
Sent: Friday, August 07, 2015 11:11 AM
To: Daniel Reis
Subject: RE: Websites to look for pits
I have to go look at it. He said the bottom of our is open and the sides have holes.
It sounds like I would put gravel unset and around the sides of it
On Aug 7, 2015 11:09 AM, 'Daniel Reis" < Daniel .Reis @putnamcountyny.t,ov> wrote:
.. o_ � a. t1 h ice : e xa: etia `;al it �i ►ue U ;'r`MIea5 be3;i�rihan riu n'r t tai , : w:e
that tank you are talking about seems shorter than the recharger, does it have holes in it?
From: Francis Williams [ mailto:fwilliams0721 @gmail.comI
Sent: Friday, August 07, 2015 10:39 AM
To: Daniel Reis
Subject: Re: Websites to look for pits
Thank you for the email
Am I looking for recharges? Cisterns?
What I saw on the cultic site and the infiltrator site looks like what u have currently installed.
I called winemaker two dais ago. The smallest yank they have is 70" long 34 "wide and 16" tall and it had a 100
gallon capacity. Would this work?
Lastly when I dug further under the exit pipe and there is a cinder block seepage pit about 2ft wide by 2 ft deep.
q
Should I send pictures? I think I have to remove some or All of this structure
On Aug 7, 2015 8:34 AM, "Daniel Reis" <Daniel.Reis@putnamcountyny.gov> wrote:
Mr. Williams,
http://www.sliydei-net.com/OurProducts.aspx
http://infiltratorsystems.coin/products-solutions/tanks
hqp:Hcatalog.cultec.conVviewitems/sel2tic-products /contaotor --- recharger-septic-chambers
also, you can call ESP in Cold Spring and ask for their advice or Winwater in Carmel.
94aed P. Rea
Environmental Health Aide
Putnam County Department of Health
Brewster, NY 10509
(845) 808-1390 x43130
2
Christina Walsh
M: Isa ..�- �,:= .r�m. � t � ^.%.•`- ee'c-._�W.�c•= ••w� -e'. r:. v`,- :�'•.'ar~ �: ",�`a..r..+.os= �:X�q.: %o, :a .ia:ro't.�.i'm��. »� -�-
ro Seymour
Sent: Monday, July. 20, 2015 9:39 AM
To: Christina Walsh
Cc: Daniel Reis; Marianne Burdick
Subject: FW: 26 Harper excavation
Attachments: IMG_1570.JPG; ATT00001.txt; IMG_1571.JPG; ATT00002.txt; IMG_1572.1PG;
ATT00003.txt
Chris, Please print pictures and add to complaint. Thank you
- - - -- Original Message---- -
From: Rich Quaglietta [ mailto :RQuaglietta @putnamvalley.com]
Sent: Monday, July 20, 2015 8:11 AM
To: Lisa Seymour
Subject: FW: 26 Harper excavation
- - - -- Original Message---- -
From: Nicole Prontelli
Sent: Wednesday, July 15, 2015 1:19 PM
To: Rich Quaglietta
Subject: FW: 26 Harper excavation
From: Susan Midlarsky [mailto:susanrm @email.coml
Sent: Wednesday, July 15, 2015 1:14 PM
To: Nicole Prontelli
Subject: 26 Harper excavation
t u "
.r._...£`. . °°°�,' : .-r� vx.c••.� .>,- �..�•La''•'��•'Y °;..rJ -_. ... ,: !.:':sc..: - = ;.7-^-. - rr. .l >.�^ '°°, i7.- '....�r:'-+:.^ir. ,l `
% • f•..
r� J
.GeyrW `"T ^��+tS. .�A�� . t �.y'• p+� ,'�,y. .
- T �t J- �� 'F'• i G �.y '• i-S' t �'%yy lF i ��T ^� Y+ .9.t�� � r'�j •1 � ,
_ zy ,� '�i,.,.�'•'' ->Y - a+' '�' � A> .v ;.: i ti 'a . �,,,� 'eC.•iiP.t �q> Y'ti'1. i si�l1
d 3. �_ c S, � 3s..'• $"' i; -'id � .. s :� +��� ��•-. +d }� � �. � � ��;,, � , iF - ^ ,g : r Trr- s • � �?r' r' r;�?v:
�yg-� ` :'r-� .� ro •,c *sic:= �s� fiw' ,�,,�y , �7r � ur _ ^�` _ . r �.7'r �t'-�r� 7 �� r -'�, �, ... fig- -w' �, --�F� %� }�f� + - �.: .;.�..��
.+- gyp! t ✓ � ;- �„ _ _ - `t „' ,� � _ ,r: �, •. �' � _, -r.,4 ,r
�, � �yL J #,. 1 !� � yt, ,x, - t v .'q ' ��Y �„ � ".. w. r• I �, 1
oa i / ► f
~�, Rf� fir• ^1 .� \, � "�t •` � .f9 • _ ,„3 - sr. -yb { •r '..�.. �' r w • fr
r � t
�. \�"� rf � fizz .'� � ,x ;.. y !, •
� � tit ! � ••� �
x
.7'
' k� ✓ rttx'
{�r� �) p.
R,
1
v
�r111 1
I IVN n 1�'• ^„t"\ s�L'F+• T ? "y.v, '� t'iv v. ; R Y s
1 31
Av
fi..
( V f�J '•Q� $ ?f {N k`�5t
{} i:�Fa � {jl:'��(+5 t;!1��•�s Qyj �
�� L s; xyi .\• �S Wei ± "•� .e�' : ai � � � t � � , + !w � +� � u �.14 -31 � �;�: � ,t�.� .
,$ Q
VI
It
4
� "'v
Ar _ $► yn ,(' 3, j'+J/�q('�q Jy�— r'a e.,f' 3"" �✓• �—,�a
b
4S
as �p
I
w
\`•k...4
-�
r.c• --; '�!.'. * ^�. -.'1 -� r{r.,r,t,. _, _...r, � - •�';'a� °rP�.a� -.._. "'?.t'��.Y+^= •v � �� � � ... _ ..-. ti. `� _ �c �. y,�; ;2.:..
y -r
f
-
V� ... 45X "+7.%23 J' s d .iY:. Y ._ .. - y. _ m• � � �- -.��. . _•2� •.ei �; .. W .,. .
a� >oa.. --e-, �,a�.,.�m y^ �- Y'G1:c e�F-r .ca.�^�� .�yc -,. �o.'+v.��..- ,. ... -,ca c- j`.y�°:-� •.o .ate g.o.�e.��+- ,'.,vim .'���.•�s•;�C -� -s- �..�3.. -.x^ -
Nl-
,93� ■ l r Y 1 4;�'
n �
r r
,
. � �•.• �; .� l rte. ;�� � ',� `i; ?: , -y. a7 �- - �'
e A,' °Y •e' ` ;" z: ,,•y �':`�ii' �'.? � .n.,�s, 'v vg+.t \ :. �'t _ �Y` a�`-" ° � _.- U .
. �• Wit` � �" .��C "ai4i. #arw• g�; 1�'t y :',�` 's
Putnam County Department of Health
Complaint Form
After Hours Log # Complaint #:
Time Received: (after hours only) Time Ended:. (after hours only) Total Time: (after hours only).
Date Received
Logged By
How Received
Received By
Referred To
City: V State:
Contact Phone: (. ) % ��3 7,7 Emaj
City:
Phone: Email:
Tax Map # Facility Code:
Nature of Complaint: (briefly describe)
owl.
00 M
Putnam County Department of Health
ti
Complaint Form m
y0
After Hours Log # Complaint #: y / 9 V��l
... - - — ,,;.w = r "� -s. - �wl§�s;r.:i�ao- ar <a, •...r.,._. �,_ ._. _.. -. ,_ ..-� -� ���y � s: �e:: :.'.:�:iw •r v` -.. �= ra%"fi: os•�v± tea!
ajgi.=
Time Received: (after hours only) Time Ended:. (after hours only) Total Time: (after hours only)
Date Received
Logged By
How Received
Received By
op
Referred To
7b D 1(,rZ
Person Making mpla'nt:
First Name: Last Name:
Street:(Q
City: V
Contact Phone: i ) (,o :a:? -7-7
State:
Email:
Zip:
Origin of Complaint:
First Name: Last Name: �_�ac..�
Street:
City:
State:
Zip:
Phone: Email:
� ... .i ::r...:.c -• _ -.. - - .:� :. -' _^ • �-'. �. a -' :- _ �_e- .��._- _� -. .r .r.vss. -ter -.�_. _..�. ��' -.v- -
°-° acility Code:
Action Taken:
jmg 11/24/14 v
mow
I k'A"D P VA ANO-A
el
Property Details - Image Mate Online
A6G. .
nage Mate Online
Page I of 2
: " -' a
Navigation GIS Map Tax Maps DTF Links Assessment Info Help Log In
Residential
Property Info
Inventory
Im:provernents
Tax Info
X :Report -
Municipality of Putnam Valley, Town of
SWIS:
1 372800
iTax ID:
83.82-2-53
Tax Map ID / Property Data
Status:
Active
–7—
IRoll Section.
TTaxable
Address:
26 Harper St
Class:
-24
Family Res
Class:
g -;�;i
Family Res
Ownership
Code:
Site:
Res 1
In Ag. District:
No
Zoning Code:
LP - Lake
Peekskill
Bldg. Style:
Ranch
Neighborhood:
28100-
School
Pistrict:
Putnam
Valley
Legal Property
Description:
10600000610310000000
000690000101000000000 106-1-31
Total
Acreage/Size:
69 x 101
Equalization
Rate:
2015-
100.00%
Land
Assessment:
2015-
$61,600
Total
Assessment:
2015 -
$225,800
Full Market
Value:
2015 -
$225,800
Deed Book:
1809
Deed Page:
173
Grid East:
j662750
IGrid North:
1912076
I PhotoaraDhs I
No Photo
Available
View Tax
Map
Pin Property
on GIS Map
View in
Google
Maps
View in Bing
Maps
Map Disclaimer
http://putnam.sdgnys.com/propdetail.aspx?swis=372800&printkey=08308200020530000000 7/20/2015
%�3a�15
T
- -.. •. - .. r.. ..G; i _.....c- •v � � ...� s io-. -' .. -... ...... - - .-. .. .. r-.-. ..-. .r.nT..n , -a.-.. .- • � n .- ^.J.r. ', r. -..... . -...
jti k
Complaint Information
Log # 130- 15- 19OW0: Complaint Received 7/13/15
Rcvd via Telephone Time Received
r Complainant (Person Making Complaint)
Anonymous
First-N6 m =` ''' ' Last.- Rintz-Z=
Address 28 Harper Street
City Lake Peeksill State NY Zip
Received By Walsh, Christina
Assigned To Seymour, Lisa
- Origin /Source of Complaint
Origin /Source Francis Williams Complaint is Against
Address 26 Harper Street Complaint- General
Phone - _ q I `� Facility Address
--5
iLocation PUTNAM VALLEY
Operation Type Complaints not associated with a eHIPS Facility Sub -LHU
i
Category A condition, action, activity, place or area that is ann. Risk Level No risk assigned
I
F- Complaint
.r,
I�
-7vu= COUNTY DEPARTMENT OF HEALTH
I
DIVISION OF ENVIROI ENTAL HEALTH SERVICES
- APPLICATION TO CONSTRUCT' A WATER WELII.
��,.:. � � :T.� — ,.a, -,,, _...:.:E'er:- l�r'c�rPE` �.:. -;,. s�� • : a�e:� -- =� � «•:.:,� ,. ��:C7:� i'8rm1•
Well Location:
Stre Address: Town/Village Tax Grid #
cwpersh kf (• MapS3,P, Block Q Lot(s) 53
Well Owner:
Name: rrca n e + 5
Address: j -6fi,
11-.L n 6
c--iE1_- ,5 K IL� Al 105-3
Use of Well:
_I 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 -fir gpm #People Served 1 °a.. Est. of Daily Usage `
Reason for
Replace Existing Supply Test/Observation Additional Supply
DriiRing
New Supply (new dwelling) Deepen Existing Well
lieit iled Reasons
_ 5,a2. -
for Drillings
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: Wt-66M ao n kAddress:
Is Public Water Supply available to site? ...... .............................. ........................... es NQ
Name of Public Water Supply: Town/Village
Distance to property from nearest water main: }
Proposed well location & sources of contamination to be provided gn separate sheet/plan.
..--• "a fT'1
Date: ° (p _ ARplicant S ia.�.re:
PERMIT TO CONSTRUCT A WATER WELL
Ths permit to construct one water well as set forth above, is granted under provisions of ArticlCJ 0 of thq�i
Putnam County Sanitary Code and Subpart 5 -2 of Part 5. of the New York State Sanitary Code -mod pt ed
Hitt within thirty (3.0) days of the completion of water well construction, the applicant or their designated
relresentative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in' accordance with the
re(uirements 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
wdl driller shall take appropriate action to assure that any and all water and waste products from such
wdl drilling operations be contained on this property and in such a manner as not to degrade or otherwise
coitaminate surface or groundwater.
AIPROVED 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
a=nded or modified when considered necessary by the Public Health Director. Any revision or alteration
ofhe approved plan requires a new permit. Well to be constructed by a w�ter well driller certified by Putnam
Canty.
IIDae of Issue 3-1- Permit
Dae of Expiration - 1 Title: _
Pewit is Non- Transferrable
Whe copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Mange copy -Nell driller
Form WP -97
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
Mr. Francis Williams
26 Harper Street .
Lake Peekskill, New York 10537
Dear Mr. Williams:
March 1, 2006
ROBERT J. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
Re: Well Permit Application for
Williams Property — 26 Harper Street
Town of Putnam Valley
This Department has approved the revised well location for the well on Permit # W -7 -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 50 feet from on -site and/or adjacent subsurface sewage ....
treatment system areas., .-- - - -- _ _
3. The well shall be installed with a minimum of 87 feet of casing.
4. An ultra- violet light disinfection unit shall be installed on the incoming well line to the
dwelling.
5. A water sample shall be collected and analyzed for coliform bacteria after the well is drilled.
The 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 feel free to contact this office.
Michael J. l
Director of
MJB:cj
cc: Insite Engineering
6t:
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
e�
4vt rq - _:F-
^ :..^.':•G"�w'Ja�E^.�G- �.'�'+•l: ,r, f.••�1%z.r -. .t1 _ �� 53•^ ., 4•. ns"is �i•.a; R'.^ a•• /�a�F:.Y rG'.:.eo':d'. 'u°�i1::6 •1`C- Tr+`�.5�.�.R����� ����s^7 o.Y. ♦i -.•.•M ��9
�tARPEc? LKf�SKL
26 ! /
29- S ho L>j n
5Tf, d /U)P, I I
Q 1eCk SQ_ e o ire ,c`. +V�9- C 2i � ':� Q,6 ve
roeef+
V
TO 39tld SWGI-iiIMI' SEE08ZSSb8t 65 :Zt 600Z /b6 /60
Page I of I
Putnam Countv Tax Map Printout
28
43 r r k 31 St`
27 28_
28
32
2D
44
30
31
0 32
Cd 33
26
34
z
01 36
1 010 2
z
48 :37 405 5'
45 30
IOD
/'. 47 \40
9D 48
55 4.5
52 f
<
L kln
28
4 24
5 67 IA
t a
e2A
22 66
Is 21 84 53 4 II
7 26 29
2
27
Diwaiumer: Putn' tantte a* accurak of the dat*pres0fitee Inforination
bg u for, reference oses tabu
t , be use(Wor con0vanpes.
Dl _+• oL
http://imsserver.putnamcountyny.comIFreeancelClientIPublicAccessllprintFrame.httnl 2/8/2006
T 'd 30 1N3WIddd3a AiNnoD WdNlnd : 3WdN :.. :�LZ -Sb8 X31 .'b : t• i �i eZ- -�33d
--
To:-Mike .Budzinski
From: Francs X. Wilharris- \ ` j �°�'� "OaC�3�)
RE: 26 & 28 Harper St properties in Lake Peekskill, 10537
My question is around the issue of skiing a well between the 2 aforementione(t-
properties or if I am able to drill a nee,, one on the 26 Harper St. property-
1. Tax map provided for Harper .treet
2. Parcels listed as 53 & 54 have been re -num enW by the town as 26 6t 2S
respectively)
3. 28 Harper St. has a well (locat,on shown on the �Ine {used tax map... IU :ie�_ ,•..,, ;
the street, 11 feet to the right. tieptic Tankis §5 feet;from the well aad.uI;irk5:,J oi;
the enclosed tax map and the Septic field is 65 feet acid marked on
tax map.)
4. 26 Harper St. has no well ( Septic Tank is 6:5, fe t from the well en' 29 Barpe.r as
marked on the enclosed tax tmip, it,is also 64.,lect from tie street wid 24
the right of the staircase as may ked on the enclosed tax map)
Given the 26 Harper St. dimensions, e•u, a well be drilled on this property or is sharing
allowed with the 28 Harper property? if a well van be drilled, is sharing with the .
property allowed on a temporary basis to continue to have water at 26 Harp;;r EM(
for how long`?
Thank y u
F
1
Francis x: ......
01
TO 39Vd dIb1S3M 9TL89V6PT5 9.0Oz/Z01Z0
m
\ •J ;< ;
ru
ru
10r ?.55
AC
ALL
If
Jw
t t i52 t 'fit �` t "� �' •`
Am
T t 1� j \
fL,R�
��„� p.? _ /0 9•(.26 -2.28 s y ;
83-75 .199
PREL MAP
63. b
3 . IAARY m 83-83
4
SCALE
TOWN OF PUTNA ;
910.27
� VALLEY
� PUTNAM �� -
0UNTY, NEW YoRx GATE OF +CAI 4• � 130 R, +� �iG..... �0.6T �4?E # 11dP..,..� {'ii•Qq
0 St41M KAK l! TES NX
rn «uav a asr
Nk
to
im
4 45a 7'
to•�as jr
1p3 AC.
Ae e c ,g
Jv
J
! 5 ssw 6®
1 1 ! 1 J.-
Ira OD
�P /0 91-26-2-28 a {:
N 912000
3.75
99
PREL Mq e3. b2
P .
� .
. A
Y
83.83 r; SCALE 50
TOWN OF PUTNAM VALLEY
91. 1 � SO , ,
�� PUTNAM CO U T U. 00 ao
N Y, ;NEW YORK RATE OF AERIAI, PMTOCRAM . ..... 4.10.07 DATE of MAP ..... 2• I7-89
�1. � ����` _ / n NY STATE KAW COORDINATES ARE X13 IN FEET
Se,Q -i-(�' -FAN � �E1 7 V �`( �- 1- �i�b�8"Z rtusym loft F44PM
t -FAN i#
PUTNAM COUNTY .DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
DESIGN DATA SHEET - SUBSURFACE SEWAGE TREATMENT SYSTEM
Owner: J C� SG /� , �� l�l G j�1 Address:
Located_ at (street): TM # O 2 , r l " s ---5 Municipality: � �)G1�1(l,. Lk-, Watershed:
SOM PERCOLATION TEST DATA
Witnessed by:
Date of Pre- soakingi Date o0ercolation Test:
Hole
No.
Hole
depth
(Inches)
Ran
No.
Time
Start— Stop
Elapse
Time
(�)
Depth to
water -from
ground'
surface .
(inches)
Start - Stop
Water
level drop
in inches
Percolation
ate
min/inch,
2
i� a �►
4'
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Notes:
1. Tests to be repeated at same depth until approximately equal percolation rates are
obtained at each percolation test hole. (i.e., :5 1 min for 1 -30 min/inch, < 2 min for 31-60 min/inch).
All data to be submitted for review.
2. Depth measurements to be made from top of hole.
Fonn DD-97. pg 1 of 2
TEST PIT IDATA
DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES
DEPTH HOLE #� HOLE # HOLE # HOLE # HOLE # _
G.L.
0.5'
1.0' Q
2.0' Ur
2.5'
3.0'
3.5'
4.0' Weq �G6�
4.5'
5.0'
5.5'
6.0'
6.5'
7.0'
7.5'
8.0'
8.5'
9.0'
10.0'
Indicate level at which groundwater is encountered f V
Indicate level at which mottling is observed
Indicate level to which water level rises after being encountered
Deep hole observations made by: 0, -G Date
Design Professional Name:
Address:
Signature:
Design Professional's Seal
Revised July 2013