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Home My WebLink About4766DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 91.26-1-66 BOX 36 04766 I ex i 4 .9r 1'6' JA 04766 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES ` w` , :: _::P'✓ATT()N TO CONSTRUCT, A WATER WELL please print or type Well Location: j2 Street Address: Town/Village 4 ir , ok Lot( LL t p c /'7 ts) �� 3 WeU Owner: Name: Address: Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigati n 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 Drilling Replace Existing Supply Test/Observation Additional Supply 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: 4. A soy Address: �AX_e_— l�-e -e «S k ; L. L 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: / 3" '.- ': - Applic?nt SSi i;; : J � 9. � rr'` PERNHT TO CONSTRUCT A WATER WELL' This permit to construct one water well as set forth above, is granted under provisions of Artic1(740 of d M Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code d prS that within thirty (30) days of the completion of water well construction, the applicant or their d gn . b representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accord ancvith requirements of the Putnam County Health Department. 3) Submit a Well Completion Report o0a foggy 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 ter well driller certified by Putnam `County. Date of Issue Permit I g 0 cia1: Date of Expiration — —o Title: Permit is Non - Transferrable White'copy - HD file; Yellow copy - Building Inspector; Pink copy - Own Orange copy - Well driller Form WP -97 /G tsay� PUTNAM COUNTY DEPARTMENT OF HEALTH H �.. _ 8�•+rT' ^ <iti•f 91QN" TTW ?$i'� O N EE` �l Ki,113 1�E Qto`-' �i' -� Sr APPLICATION TO CONSTRUCT A WATER WELL please print or type PCJW- # VJ I Well Location: Street Address: Town/Village x ir�id # ,. 4 vea �Z l sus 5'1 ` ?.c JCSA J L L . J p ock %7 Lot(s) /.2 Well Owner: Name: Address: Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigati n I- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served o, Est. of Daily Usage _gal. Reason for Replace 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: A s ®b. Address: Is Public Water Supply available to site? ..... ...................... ............................... Yes No Name of Public Water Supply: Town/Village Distance to property from nearest water main: P> oposed:well location & sources of co- ination.to..be..,provided on.- separate sheet/pjan.:. = Date: / r` ®,'___ Applicant Signature:. PERMIT TO CONSTRUCT A WATER WELL r max, This permit to construct one water well as set forth above, is granted under provisions of Artic1�0 of Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code W prR that within thirty (30) days of the completion of water well construction, the applicant or their dffign representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordanct,.Awith e requirements of the Putnam County Health Department. 3) Submit a Well Completion Report ova fog < provided by the Putnam County Health Department. During all well drilling operations, the apocant 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 ter well driller certified by Putnam County. Date of Issue . (ice Permit I 'ng 0 cial: Date of Expiration — --o Title: Permit is Non- Transferrable White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owneg; Orange copy - Well driller SHERLITA AMLER, MD, MS; FAAP Commissioner of Health aa;... a ..-tea •:- .::,i5 +. x.. -- ... �..:� °'....5,.... =, +i�,, s ':a�:. .. `LORETTA MOLINARI, RN, MSN Associate Commissioner of Health January 12, 2005 Allen J. Sloane ROBERT J. BONDI County Executive .�.� w�FS.�V.L.. '- � ' L �... RL.O',i .` T . r.. .- � .i�.:M:.i..: n4a e ti _ nr, .. a• ,. .DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 3938 Palladium Shore Drive Boynton Beach, FL 33436 I:Z0 Dear Mr. Sloane: Well Permit Application for Sloan Property — 46 Mathes Street (T) Putnam Valley This Department has approved the well permit for Well #W1 -05 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 65 feet from on -site and/or adjacent subsurface sewage treatment system areas. 3. The well shall be installed with a minimum of 76 feet of casing. ultra- °;ziolet.l?ght= sllfectiq "t?n.ii seal) i_ 1�: Y. iistlled:bri :tli�'aric�ifnng:weI :lined �_ to the 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, please contact this office. Michael J.1 Director of, MJB:cw Cc: C. Santos, (T) Putnam Valley Mr. Anthony Tripodi Insite Engineering Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 1 K. PUT NAM COUNTY ]DEPARTMENT OIF HEALTH DWRSRON ®IF IEI OIMIENTAL HEALTH SIERWC ES ;. APPL.I PI[ IEILIL :t # iA - � -`o'S please print or type Well Location: Street Address: TownNillage �r�id #� �� VO ja .14, (� A �S �:raSX a tp ock /7 Lot(s) /1 WellOwne>r: Name: La.i m 4 e Address: Use of Well: Residential Public Supply Air /Cond/Heat Pump Irrigati n I- p>rimairy Business Farm Test/Monitoring Other (specify) 2- secondairy Industrial Institutional Standby Amount of Use Yield Sought gpm # People Served e�. Est. of Daily Usage _gal. Reason for I<Drining Replace Existing Supply Test/Observation Additional Supply New Supply (new dwelling) Deepen Existing Well Detailed ](Season for BDa"ilflinng 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: A -s®%,, Address: �°�� a (-L '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: %� ....:A1spLcwt..Si natut °;;: PER MIT TO CONSTRUCT A WATER WELL `� � c ' 1t This permit to construct one water well as set forth above, is granted under provisions of Artic100 ofit i` E `' Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code agd prov e: that within thirty (30) days of the completion of water well construction, the applicant or their d, gn C3 representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordancl' . mth requirements of the Putnam County Health Department. 3) Submit a Well Completion Report ova fo 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 drlling operations be contained on this property and in such a manner as not to degrade or otherwise contarniiaate surface or groundwater. APPROVED _IFOR CONSTRUCTffON: 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 ter well driller certified by Putnam County. 1, A r . , Date of Issue , Date of Expiration — —o Pe>rnnnnt � Non -Tn annsffen rabRe Permi Title: White ccpy - HD file; Yellow copy - Building Inspector; Pink copy - Orange copy - Well driller Form WP -97 01/10/2005 10:45 9142430307 f-1 ID 1 L "1' PAGE 02 i ':�i:osn<s.0 •'.G%r,.i ., - �";.,tww" �-�." m..:. ;t` -:.:o. -_ . . w.. r.. oi. '. . .. _,. :.,mow. .,.iw �,�%iw . „ ... .a -i .�'X.. y. .r . 'T-.�> .. �... ., �, - COLDWeLL 366 UND)ERHILL AVENUE t' YORKTOWN HEIGHTS, NY 10508 BUS. (914) 245 -3400 FAX (914) 245 -8642 RESIDENTIAL. BROKERAGE Ja uary 5, 2005 Mr: Mchael`Btitda osid Putwin.County Dept. of He f Geneva Itd: ' Brewsw, New York 10509 RE: 46 Mathes St, Lake P 1— Sloan Property Dow Mr. &mUinski: Per our phone conversation o ammy 4e",1 am sending this letter to.request that the well .pmh. for the above me *0 property be eat to the Sloan's attorney. This property Is currbnEly under ooatract to Greengrass and is pending a closing conditional upon ptt ft* well p ' "t add su uemiy drilling a well 1blr. Anthony Tdpodi 40 Triangle Center .1-^528 Alf, parties have been notified are in agreement. - Please feel f w to call me with any questions. Thank you far your mpt attention to thit;r matter. FdisrBt Aiut►a- 11Tdili; GRi Coldwell''Banker Resiidential l Cc: Mr. Anthony Tripoik Esc '' Ms' �ohn Manning,'EBq. 114s` Francesca iHiilone, H Mr. end Mrs.. Sloan x wned And Operated By NRT incomorated. JAN -10 -2005 .MON 10:47 TrL:e4! 9 -7921 dtd'':.'- :iJTNAM COUNTY DEPARTMENT OF P. t SHERLITA AMLER, MD, MS, FAAP ":;,�orr�taiaer.aealth k LORETTA.MOLINARI, RN, MSN Associate Commissioner of Health January 12, 2005 Allen J. Sloane DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 3938 Palladium Shore Drive Boynton Beach, FL 33436 Dear Mr. Sloane: ROBERT J. BONDI County Executive Re: Well Permit Application for Sloan Property - 46 Mathes Street (T) Putnam Valley This Department has approved the well permit for Well #W1 -05 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 65 feet from on -site and/or adjacent subsurface sewage treatment system areas. 3.. -Tbe., �g-1 -slkall- be.installed with a.minimum.pf_,Z6feet of casing.I 4. An ultra- violet liglt disinfection ilhit'sfiall'6e uisfa7leii Sri tiie 1n utrii�g�eTlti>= - - 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, please contact this office. Michael J. i Director of S R: Cc: C. Santos, (T) Putnam Valley Mr. Anthony Tripodi Insite Engineering Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP Co.mmissioner_of Health LORETTA.MOLINARI, RN, MSN Associate Commissioner of Health January 12, 2005 Allen J. Sloane ROBERT J. BONDI County Executive i.... ate_- ti ^...m.. <.M ��.�a... -. ... �i,._. - -•.- �:...�. �. n.+,... _ - -__� DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 3938 Palladium Shore Drive Boynton Beach, FL 33436 Re: Dear Mr. Sloane: Well Permit Application for Sloan Property — 46 Mathes Street (T) Putnam Valley This Department has approved the well permit for Well #W1 =05 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 65 feet from on -site and/or adjacent subsurface sewage treatment system areas. p 3.. The well shall be.installed with a minimum of 76 feet of casing. "4. - Aii'u1fra--,66let light "disinfee iori unit slrat-I-bir ihGtal ed- cn-thE inco�m n �'vell.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, please contact this office Michael J. Director of MJB: cw Cc: C. Santos, (T) Putnam Valley Mr. Anthony Tripodi Insite Engineering Y, Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 SHERLITA AMLER, MD, MS, FAAP Commiss ones of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health January 12, 2005 DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Allen J. Sloane 3938 Palladium Shore Drive Boynton Beach, FL 33436 Dear Mr. Sloane: ROBERT J. BONDI County Exgcunv.e Re: Well Permit Application for Sloan Property — 46 Mathes Street (T) Putnam Valley This Department has approved the well permit for Well #W1 -05 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 65 feet from on -site and/or adjacent subsurface sewage treatment system areas. 3. The well shall be installed with a minimum of 76_ feet of casing A ° ` . ' Air u1tr2T violet light u srnfectic;ri ut�it slyd i lse i§ralt d oirthi✓-iti or ng 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, please contact this office. ectfully, Michael J. Director of MJB:cw Cc: C. Santos, (T) Putnam Valley Mr. Anthony Tripodi Insite Engineering Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Intervention/Preschool(845)278 -6014 Fax (845) 278 -6648 ......... . t -j4 rn v(" �a7x (24 t Cw q /0 'ILI —V-Foc Ux 460 PUTNAM COUNTY DEPARTMENT ENT OIF HEALTH 1(DMSIION OF ENVIRONMENTAL iHl}EAL'II`PI ERV1«IES Well Locations Street Address: To Village: i ax Grid# Map Block Lot(s) Well Owner: N e: Address: A4l Use of Well: I- primary 2- secondary Residential Business Industrial Public Supply Air cond/heat pump Irrigation Farm Test/monitoring Other(specify) Institutional Standby )[Drilling Equipment Rotary Cable percussion Compressed air percussion Other (specify) Well Type Screened Open end casing /,--,,Open hole in bedrock Other a Total length C ft. Length below grade yft. / in. Diameter � Weight per foot lb /ft. Materials: /-, Steel _ Plastic _ Other Joints: Welded � Threaded Other Seal: XX Cement grout Bentonite Other _ Drive shoe: X Yes No Liner: Yes No_. Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test _ Bailed _Pumped � Compressed Air Hours Yield �— gpm 1Depth Data Measure from land surface- static (specify ft) During yield test(ft) • Depth of completed well in feet � D Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) ]Formation (Description ft. ft. Land Surface q6 p ,.. , . �-• a ..... . , . '� .... _. _ _ V If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information 3 3! Pump Type Capacity S Depth' Model 5 S' I c Voltage y3v HP Tank Type yS o Volume Y � 7 Date Well Completed .Y � d S/ Putnam County Certification No. Date of Report 5' / F- o Well Driller (signature) ". % , 6S -J, -L.- NOTE: E ct location of well with distances to at least two penman-fit landniarks to be provided on a separate sheet/plan. Well Drillees Name ) 4ze, -r . Address: Signature:T_ Date: 0G y White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WC -97 MAR -20 -06 MON 12:33 PM FAX; PAGE 1 YML ENVIRONMENTAL SERVICES 132 _Kean Street .Yorktcxwn He'xyit'e; "N:Y. (.914) 245 -2800 Albert H. Padovani,, Director ;LAB #: 1.601497 CLIENT' #: 59228 NON STAT PROC PAGES 1 wr,YNNNrrYYYYYNI.h*-- -- ----NN -- -------- -------------------- NNnrYN :GREENGRASS, JOAN DATE /TIME TAKEN: 03/11/06 11:00 '46 MATHES STREET DATE /TIME REC'D: 03/11/06 11:25 :FAKE PEEKSKILI ,,, NY 10537 REPORT DATE. 03/20/06 PHONE: (845) -284 -2426 'SAMPLING SITE: SAME AS ABOVE SAMPLE TYPE..: POTABLE PRESERVATIVES: NONE .COL' D SY : JOAN - GREEN miss TEMPERATURE..: <.4C NOTES...: KITCHEN -TAP COLIFORM METH: MF NhNwr— nrY - - -- NNE ------------- ~ -------- N— -- - - - -IM NY----- -- YYNNNN N-- YY-- NNN- - - - - -- DATE FLAG PROCEDURE RESULT NORMAL h RANGE METHOD 03/11/06 MF T. COLIFORM ABSENT /100 ML ABSENT 1008 COMMENTS: FAX TO 591 -4828 COMMENTS-.' BACT THESE RgSULTS INDICATE THAT THE WA (WAS) (WAS NOT) OF A SATrSFACTORY SANITARY QUALITY ACCORD NEW YORK STATE AND EPA ,FEDERAL DRINKING WATER STAND FOR THE PARAMETERS T A LECTION..;. P . _. --: .. r .: .. ... - .�. ..i .. .... .. -... ,,. ._.y .. .._... .�. . .. i .. .. a ... .. .... ._ ..,., r .. .y.. n...a.... -. t. ...r.:t;r ...a ... 51• z �.... .. .. u •SUBMITTED BY: ELAP# 10323 a's a z a a a a