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Home My WebLink About0035DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 3.-1 -58 BOX 1 i r r i rr `ti_ rl • r T or T■ I i r 00035 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or type PCHD Permit # J-4— Do Well Location: Street Address: Town/Village Tax Grid # 156 Route 292 Patterson Map 3 Block 1 Lot(s) 58 Well Owner: Name: Address: Michael Gury 200 N ala Farms Road Westport, CT 06880 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 I Est. of Daily Usage C�1� b gal. Reason for x Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason Existin a well is contaminated P. for Drilling Well Type x 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: Address: 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 sep to et/ an. Date: 5/31/2000 Applicant Signature: Perry L. Bea 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 Wei 1 driller pertified by Putnam County. Permit I s in i 'al: Date of Issue 12w)A, �'�- Date of Expiration Title. Permit is Non -Trans 64aAb9le White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 P.F. BEAL & SONS, INC. 4 PUTNAM AVENUE ARTESIAN WELLS BREWSTER, NEW YORK 10509 WATER SYSTEMS JET PUMPS 41aM4,6ed IRfl - Qv. //,430 &*14 L'mmp&?W SUBMERSIBLE PUMPS TEL. 279 -2460 - 2461 FAX 279 -6613 COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERIVICE May 31, 2000 Putnam County Health Dept. 1 Geneva Road Brewster, New York 10509 To Whom It May Concern: WATER TANKS COMMERCIAL WATER SYSTEMS HYDROFRACTURING WATER CONDITIONING EQUIPMENT Enclosed please find a well permit application for the drilling of a new well at the Gury residence at 156 Route 292, Patterson, NY. If this matter can be attended to promptly, it will be greatly appreciated as it is effecting the sell of this house. Thank you very much for your time. Very truly yours, P. F. Be/Jal & S ns, Inc. 14"" d� Adam L. Beal ALB /mm enclosure I a 3 �O W A O. 0 Oe �p ()Q5Q- I I�r 0O Rom a-aa P.F. BEAL .& SONS, INC. 4 PUTNAM AVENUE ARTESIAN WELLS BREWSTER, NEW YORK 10509 WATER SYSTEMS � � �1S'yl _ 0- 1%4130 &IW4 & /e JET PUMPS � SUBMERSIBLE PUMPS TEL. 279 -2460 - 2461 FAX 279 -6613 COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERIVICE June 16, 2000 Putnam County Health Dept. 1 Geneva Road Brewster, NY 10509 To Whom It May Concern: WATER TANKS COMMERCIAL WATER SYSTEMS HYDROFRACTURING WATER CONDITIONING EQUIPMENT On May 31, 2000, we submitted a well permit application for the drilling of a new well at the Gury residence at 156 Route 292, Patterson, NY. (Tax ID # Map 3, Block 1, Lot 58) A few days later we received a letter back from the Health Department detailing the "neighbor notification" process. Once we determined that there were only three properties within 200' of the proposed well location, as instructed we obtained the names of these individuals and sent out certified letters with a return receipt. These letters were sent out on June 13, 2000. As of the date of this letter, no response has yet been received. As we stated in an earlier letter to the Health Department, time is of the essence in this particular situation. The sale of Mr. Gury's house is pending until the installation of the new well is completed. In an effort to expedite the process, we have attached the three letters, which were sent to the appropriate neighbors, along with a receipt from the post office for each of these letters. If and when a response is received from Mr. Gury's neighbor(s), we will be sure to bring this to the attention of the Health Department. We thank you very much for your attention to this matter. Very truly yours, /4- a 41 P.F. Beal & Sons, Inc. Adam L. Beal • Z� 029 566 469 US Postal Service Receipt for Certified Mail 25 No Insurance Coverage Provided. Do not use for International Mail see reverse Sent to Jmm . , AR & Phylis M Street b Number P. o. Box 393- APPENDIX E Post Office, State, d ZIP Code Patterson, NY 12563 Postage $ r33 T CONSTRUCTION PERMIT Certified Fee / � 4 ( I "r O OR NOTIFICATION LETTER SPedal Delivery Fee Restricted Delivery Fee rn Return Receipt showing to Date 6/12/00 _ wr,om a o rend S S Pow Fe� ° S RE: Department of Health Review of Proposed 00 E ark or Sewage Treatment System for Property LL a �/SPS Name: Michael Gury Jeanne Dzienciol Address: 156 Route 292 A.R. & Phylis Moore Town: Patterson, NY 12563 P. 0. Box 393 Tax Map #: Map 3 Block 1 Lot 58 Patterson, NY 12563 Dear Ms. Dzienciol & Mr. & Mrs. Moore: Please be advised that an application for a Construction Permit relative to the construction of a Aryva&,ay;t ,eycy /pr well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you .have any questions, concerns or information which may bear on the Health Department's review of this application, you may call the Health Department at (914) 278 -6130. Very truly yours, By: Adam L. Beal Title: P. F. Beal & Sons, Inc. Received By: Address: Tax Map #: Map 3 Block 1 Lot 57 August, 1999 AppndxE Z 029 566 468 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. nn not uca fnr Intamatinnal Mall /Saw ravamal 25 APPENDIX E Date 6/12/00 RE: Department of Health Review of Proposed Sewage Treatment System for Property Name: Michael Gury Address: 156 Route 292 Ruth Lewart & Mr. Light Town: Patterson, NY 12563 131 Route 202 Tax Map #: Map 3 Block 1 Lot 58 Patterson, NY 12563 Dear Ms. Lewart & Mr. Light: Please be advised that an application for a Construction Permit relative to the construction of a sty WgA,tggpc¢'# well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call the Health Department at (914) 278 -6130. Very truly yours, By: ac• Y Adam L. Beal Title: P. F. Beal & Sons, Inc. Received By: Address: Tax Map #: Map 3 Block 1 Lot 90 August, 1999 AppndxE Sent to Ruth Lewart & Mr. Light Street 3 Number 131 Route 292 Post office, State, 6 ZIP Code Patterson, NY 12563 Postage $ ! ,53 Certified Fee �. O Special Delivery Fee Restricted Delivery Fee Return Receipt showing to Whom a s f&VPoAAF, s ark or D o i vsPs 25 APPENDIX E Date 6/12/00 RE: Department of Health Review of Proposed Sewage Treatment System for Property Name: Michael Gury Address: 156 Route 292 Ruth Lewart & Mr. Light Town: Patterson, NY 12563 131 Route 202 Tax Map #: Map 3 Block 1 Lot 58 Patterson, NY 12563 Dear Ms. Lewart & Mr. Light: Please be advised that an application for a Construction Permit relative to the construction of a sty WgA,tggpc¢'# well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call the Health Department at (914) 278 -6130. Very truly yours, By: ac• Y Adam L. Beal Title: P. F. Beal & Sons, Inc. Received By: Address: Tax Map #: Map 3 Block 1 Lot 90 August, 1999 AppndxE Z 391 338 561 Us Postai Service. Receipt for Certified Mail 25 No Insurance Coverage Provided. Do not use for International Mail See reverse Sent to George Seitz Street & Number P o Box 34 APPENDIX E Post office, , state, , & ZIP Code Brewster NY 10509 Postage $ , 3 3 CONSTRUCTION PERMIT Certified Fee (' IR NOTIFICATION LETTER Special Delivery Fee Restricted Delivery Fee Retu Showing Date 6/12/00 � / _ a red to I a J e, & ee's OTAL age & $ Department of Health Review of Proposed ostma ate Sewage Treatment System for Property a LISPS Name: Mit hael Gury Address: 156 Route 292 Mr. George Seitz Town: Patterson, NY 12563 P. 0. Box 34 Tax Map #: Map 3 Block 1 Lot 58 Brewster, NY 10509 Dear Mr. Seitz: Please be advised that an application for a Construction Permit relative to the construction of a Wto �yprp��pi¢/,gt well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call the Health Department at (914) 278 -6130. Very truly yours, By: Adam t. Beal Title: P. F. Beal & Sons, Inc. Received By: Address: Tax Map #: Map 3 Block 1 Lot 91 August, 1999 AppndxE A d O Ck- VO I i J � I I � P 00 ( E Rom a-AZ Senfi �o eocL1 44 ° o orb 3.83 AC. 45 46 -� CAL 67 ow pi— At {7 53� 4 nil - 16.00 AC. CAL, � � 40.33 At CAL a 0404 11.55 AC. 3 E4 6 49 v CAI. � C. C • 4.99 'AC. 2.26 AC. .as 36 b • .q r 4.03 AC. CA � • C ►� si r m 77.20 AC. CAL QU � AC4 ! • � 1 1 I,10 a i 33 �3 20 25� X2.60 AC. $ �� 7.71 C Inca iam 27.08 AC. 26.79 AC. cp .�4 �y,;� �.76rC 1 ` 9a.p loci% i2 �ti asa �� ^ X4.5 AC. r t �•�a9 31 90 1.9 ° AC. 2.03 t. 1218 AC. Ca 7 is S 2.28 AC. 1 92 9