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Home My WebLink About4637DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 85.13 -1 -8 BOX 35 04637 Is r r m I'yL i�� % rw f R ti 04637 i a PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL 0. Wi'.Oicasc priryt-&qpe-.: 5•... =,=� �:: �D i ~eri3il$ i�, �3i f ` T i�7 `� � Well Location: Street Address: TownNillage Tax Grid # 85.13 -1 -8 31 Barger Street Putnam Valley Map Block Lot(s) Well Owner: Name: Address: 131 Kyle Walker Barger Street Putnam Valley, NY 10579 Use of Well: X 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 5 gpm # People Served Est. of Daily Usage gal. Reason for x Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reaso Existing well is going for Drilling 10 6F- Well Type X Drilled Driven Gr vel 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: P. F. Beal & Sons, Inc. Address: 4 Putrm Ave., Brewster, Ny 10509 Is Public Water Supply available to site? .................................. ............................... Yes No 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: 8 /20102 Applicant Signature: �.,...� _ ,,.tee::.;_- ;_._.. r.= �'i-s .:�5 •��^•BeL�I _�••..,, - _.r..._ ;.d .. �.......:.�_.R -_.__. PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 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 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 water well driller certified by Putnam County. , i/-11—C Date of Issue Pe Date of Expiration r Ti Permit is Non - Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Orange copy - Well driller Form WP -97 PUTNAM COUNTY DEPARTMENT OF HEALTH DWISRON OF ENWRONMENTAL HEALTH SERVICES APPLICATION TO ABANDON A WATER WELL please print or type PCHD PERMIT # k\Ah-1 ° OZ Well Location• • Street Address: 31 TownNillage ax Grid # 5" l Pi �4-k► V4 Map Bloc ot(s) Well Owner: Name- ky Lp, Wai4-f- e- Address: I AlrIO5'� S4 S¢ Z P44 7h' e"11 11411e Well Type: Drilled Driven Dug Gravel Other Depth Data: Well Depth ft Static Water Level ft Date Measured Use of Well: Residential Public Supply Air /Cond/Heat Pump Abandoned 1- pirimairy Business Farm Test/Observation Other (specify) 2-secondary Industrial Institutional Standby Water Well Contractor: Name: Address:��Q Reason For Abandonment: � i S rtA Y Description of Work To Be Performed: Ci I Cam, G r� Date: Applicant Signature: P ERMffT This permit, to abandon one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code, Subpart 5 -2 of Part 5 of the New York State Sanitary Code and /or Part 75 of 10 NYCRR and provided that: Within 30 days of the completion of the abandonment of the water well, the applicant shall submit to the Department a certified statement that the information delineated on the application for this permit has been completed. /. t— JAI Date of Issue Permit Issuing ffic'al Tit White copy: HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WA -97 Kyle Walker PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT Wo 31 Barger Street Putnam Va IMap to dria # 85.13-1-8 Block Lot(s) Well Owner: Name: Address: Kyle Walker, 31 Barger Street, Putnam Valley, 1,qY 10579 Use of Well: 1-primary 2-secondary X Residential Public Supply Air cond/heat pump Irrigation Business Farm Test/monitoring Other(specify) Industrial Institutional Standby . Drilling Equipment X Rotary _ Cable percussion X -Compressed air percussion Other (specify) Well Type Screened — Open end casing X Open hole in bedrock Other Casing Details Total length 80 A. Length below grade 79 ft. Diameter 6 in. Weight per foot 19 lb/ft. Materials: X Steel —Plastic Other Joints: Welded X Threaded Other Seal: X Cement grout Bentonite Other Drive shoe: X Yes No ILiner: Yes X No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes—No Hours Second Well Yield Test Bailed X Pumped X Compressed Air Hours 6 Yield 5 gpm Depth Data Measure from land surface-static (specify ft) 301 During yield test(ft) 5401 Depth of completed well in feet 6251 Well Log If more detailed information descriptions or sieve analyses .. n., illib,r6 please attach. Depth From Surface Water Bearing Well Diameteron) Formation Description ft. - ft. Land Surface 65 Drilling in over den clay and boulders 'it rock at 651 D -in rqqk�,1,qqt:c a z tz�i,; -�'wt .7 Diiiiing in rock granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump/Storage Tank Information Pump Type sub Capacity 5t�Wln Depth 5601 Model 5GS10412 Voltage 230 HP I Tank Type Volume Date Well Completed 9/5/02 Putnam County Certification No. 002 Date of Report 9/23/02 Well 96iler.(signature) cbilstcq� her Beal NOTE: Exact location of well with distances to at least two permanent lanamarKS to oe provided on a separate sneevpian. Well Driller's Name P. F. Beal & Sksis, Inc. Signature: Pe Cfir'i topher (seal Address: 4 Puttiara Avenue, Date: 9/23/02 White copy: HD File; Yellow copy -Building Inspector; Pinkcopy - Owner; Orange copy- Well driller Form WC-97 BRUCE R FOLEY Public Health Director DEPARTMENT OF BEALTH 1 Geneva Road Brewster, New York 10509 LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921 Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085 Early Intervention (845) 278 - 6014 Fax (845) 278 - 6648 Preschool (845) 228 - 5912 Fax (845) 228 - 6113 F.F. Beal and Sons, Inc. 4 Putnam Avenue Brewster, NY 10509 Re: Proposed Well Walker 31 Barger Street 85.13 -1 -8 (T) Putnam Malley August 28, 2002 Dear 1*. Beal: On August 27, 2002, a field inspection was conducted on the above referenced lot .by. . Daniel. adders. FL► 'ric l e�� cn T?chni� ±a 7Ch It at onst - - -- _ .. _ ...... . 1 .- 1' I o r ;place-ai' ctistuig weir is approved with the following stipulation: 1. A minimum of 72 feet of casing. must be provided for well protection. As -built plan, Well Completion Report (WC -97), Well abandonment, if applicable, and water quality analysis shall be submitted no later than 30 days after the well completion by the permittee. Please contact the writer at (845)278 -6130 ext.2235 if you have any questions. Very trulyyours, rWAJ "04611 Daniel Madden Public Health Technician cc: lam, file AM co.. W q 2 - 0.1 '^A llrXRT Sheet of PUTNAM COUNTY D NT OF HEALTH .. `_. ,.I)IV STON OF iVIF.nN�bII ]NjA , HEA.TI,I'I. F'I2ViS�F�_ W Y o FIELD ACTIVITY REPORT NAME• 2 Tph 0, eAf Street;. Town `a State .. Zip PERSON IN CHARGE 2 Na e and Ti e TYPE OF FACILITY 251` r✓lC P FINDINGS 3' °6 '+,-� a ,y L }� ; a 1' e. !. :,� s�l+� -}"ti a• � �„r., .`� f. .. .; nw •.., � ..b •.tw•"-.r -.� t ... ..w�....s .� •c..r� --G` -r 1 ��4� cam.. <...o-.. 7 �,'�ns�' - �aR�- ,; .. c- ..,_- « . to,y,� J! � .� � .... ,.� _ .«. .• — (Ca VeJacle a,n eXl's 1n�, I , U\j F. L. mkt SONS, 9NC. 4 PUTNAM AVENUE ARTESIAN WELLS BREWSTER, NEW YORK 10509 WATER SYSTEMS JETR FS.' _'w 7c'L'1zp -c'a UM- SUBMERSIBLE PUMPS TEL. (845) 279-2460 - 2461 FAX (845) 279-6613 COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERIVICE . .0.1-r low 2, (old vlot ec'g4 b a WATER TANKS .,COMMERCIAL WATER SYSTEMS WATER CONDITIONING EQUIPMENT 41: k&A ScAilmino" M 7717 P2 J. 23 211 19 20. p T- 1.01 At 1.30 AC. off AVENUE LARKsKRG Iftf0 u 33LIB ~ e 8 85 1.10 AC. Q 1.08 At I 117 ITT 8 1.4 34 rn 1.01 At 13 10 m t 12 &40 At :CAL to tmac 225 At CAL IML Ir 37 2,12 At CAL 4.42 Ar- CAL I. Ica 9 1.4; At CAL 3e 4.30 AL.CAL &10 AC. H0.q At 41.11 40 1 uta 39 t ymm 2.03 At M 41 14 1.40 At CAL .5 1.6 AC 204 AC, CAL 46 1.56 AC. M 42 0 POSEY, 41' 1.01 AC..' 1.03 Ati 1.00 to AC. 1.00 At 44 4 43 s 1.02 At. JIM, DRIVE aaI 1.01 AC. 85EIEtI FOR AMMW. PIJRFbSES ONLY - HU 51UN5 SPECIAL DISTRICT INFDRMATIoN.. I NOT TO BE USED FOR WKYAKES unew ItAN LIM ca C"TT LI call MN 17,ij I9 W s. LINK of JAMES W.: SEWALL',COW WLLAK LIM IR ANY s* LIMIT 147 CERMATREET, OLD: O.W N� �A!w ILOT LUX I. mismL La L FIM —2—zt 236 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES fi�.:./ T lL/ :. ="nJ�9 '3.1 °`�'�i 4�i' a`PiT""CY:ili1�%�' 4.:d Y! �o ' ..".,�}Q.:y", .+.o .. °• «.:+s.n:.,,�i :�°, ~ir. °""';'�'C..0 k:�. �.1 rf,.�at• �%a.n.%+. --+ �:c`� 'a "'= +oho*++ . WELL ABANDONMENT Cl i;,zdersigrd rcreuy ce�i� that�u�e-aranaoi ent zf tnC ai)ot`�e =r completed in accordance with the methods described in Permit.# Date: 3/7/03 Signature:( 1R1IFICATION ��r�it�ea v�raCcr� ell fias 8'eel?"accomplisiZed °and' °� - °' AW21 -02 to abandon said water well. Print Name: Christopher Beal Address: P. F. Beal & Sons, Inc. 4 Putnam Ave., Brewster, NY 10509 Form WAR -97 PCHD Well Abandonment Permit # AW21 -02 please print or type Well Location Street Address: TownNillage Tax Grid # 85.13 -1 -8 31 Barger Street Putnam Valley IMap Block Lot Well Owner Name: Address: Kyle Walker 31 Barger Street, Putnam Valley, NY 10579 Well Type X Drilled Driven Dug Gravel Other Depth of Well Well Depth 75 ft Static Water Level 45 ft Date Measured 8/10/02 Reason for Drilled new well due to low yield. Abandonment Description of Filled old well with concrete from bottom to top. Completed Work WELL ABANDONMENT Cl i;,zdersigrd rcreuy ce�i� that�u�e-aranaoi ent zf tnC ai)ot`�e =r completed in accordance with the methods described in Permit.# Date: 3/7/03 Signature:( 1R1IFICATION ��r�it�ea v�raCcr� ell fias 8'eel?"accomplisiZed °and' °� - °' AW21 -02 to abandon said water well. Print Name: Christopher Beal Address: P. F. Beal & Sons, Inc. 4 Putnam Ave., Brewster, NY 10509 Form WAR -97