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Home My WebLink About0099DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 3.19 -1 -46 BOX 2 111•! ' , , �- k . , -�;Fr f ., -z . �� i r� . �r r NMI 111•! �l �f q:5 d :747 PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL ' please print or type Well Location Street Address: Town/Village: Tax Map # SM. zzctp' Map Block Lot(s) Well Owner: Name: Address: j, 0 70 % Phone. #: Use of Well: 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____jr gpm # People Served . Est. of Daily usage gal. Replace Existing Supply Test/Observation Additional Supply Reason for Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason AAA for Drilling Well T e Drilled Driven Gravel Other Is well site subject to flooding? ....................................................... ............................... Yes No' — Is well located in a realty subdivision? ........................................... ............................... Yes _ No Name of subdivision Water Well Contractor:_ Lot No. Address: ) are,er �'^�` : �ngIk Ve(�ey / Is Public Water Supply available on 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: (� l Applicant Signatur . ^ %e 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 Departmer 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 Commissioner of Health. Any revision or aIteratioryryof the approved DLA requires a new permit. Well to be constructed by a water well driller certified by Putnam County! Date of Issue lz-1 —(4 Permit I Date -of Expiration 12 --4I —R p Title: e Permit is Non- Transferable "(1 ! i1!;1 n� ('+n, Pay n • White copy - HD file; Yellow copy - Building Inspector; Pink copy - Orange dopy - Well driller Form WP -97 Rev. 3/06 P'vtnam auafiy y Image Mate Online NY Residential ?v�iun cipality of Patterson To of j Property Info OW 'jr ales Inventory .. . SWIS 372400 Tax ID; 3.19 -1-46 �. improvements Tax Info Ownership inform"ation Report -- Comparables z . Name Address D�k A�ay NA 7105 Corporate Dr s . of Patterson N 1563 ". In y Sale Information: Sale Date Price' Property Sale Pri ;ts ry�� Ow 3/21/2013 $560,632 210 - 1 Farriily Res Land & Building Coul Geori . Value Arms Deed Deed No No 1920 2c t' Sale Date Price ` Property Sale PH Class . ". Type . Ow Family Building Sol Res Lio Value Arms Deed Deed Usable Length, Book .i J'. i� �S :1 .1 . { f' �I 1 Vul an:98 jo4.93 N YORK .95 V37.10 m T 3.53 AC. ,5 4e Q p9p /1 2D.58 Ila�Q7:$ 57.38 • ' �' ��' -�,a� �tr��, ��^�,�5�� "''�'�' 6-24 D�3 ri9 : 50' 0-25 ._..,;29783 �;�� . s�,..4� _. �n� •, a� � �� >°�� _,. CA t��'ng' V PUTNAM COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH SERVICES b 1 PROPOSAL FOR SEWAGE DISPOSAL SYSTEM REPAIR OWNFt'S NAME John L. Owen III PHONE SITE LOCATION okosi::£ Farm RR2 Box 387, Patterson, NY 12563 TO 3.19 -1 -45 MAILING ADDRESS gAMi PERSON INTERVIEWED PCHD Complaint # Name & Relationship (i.e, owner,tenant, etc.) DATE TYPE FACILITY Restdence (1- Family) PROPOSED INSTALLER John L. Owen, III PHONE 878 -9026 REGISTRATION # Proposal (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal fran licensed professional engineer or registered architect. Refer to Attached Plans and Letter �J f Proposal approved % Proposal Disapproved Inspector's Signature & Title to Proposal approved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. b. Site Street Name, Town and Tax Map number. c. Location of installed canponents tied to two fixed points d. System description (e.g., 1250 gal. concrete septic tank, drywells surrounded by one foot + gravel). e. Installer's name and number. (e.g.,house corners). three precast 6' diam. x 6' deep 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, o eported en f owner agree to the above conditions. SIGNATURE / / .'� TITLE �. 61/ !Z DATE 11/ -314 : *dte (PAD); YeUcw (fin BI); Pink (Applicant.) Pr -PP 07 GAINER - WILBUR CONSULTING ENGINEERS, P.C. Ronald J. Gainer, P.E., President Stanley M. Wilbur, P.E., Vice - President Mr. William Hedges Putnam County Department of Health Division of Environmental Health Services 4 Geneva Road Brewster, NY 10509 RE: Owens Residence GWPC Project No. 32 -9844 Dear Bill: Dutchess Court Plaza Route 22, Suite 201 P.O. Box 417 Pawling, NY 12564 (914) 855 -1255 (914) 855 -1780 FAX 600 Stony Brook Court 1025 Airport Drive P.O. Box 3228 Newburgh, NY 12550 (914) 562 -3430 (914) 562 -0615 FAX P.O. Box 2246 S. Burlington, VT 05407 (802) 864 -0226 (802) 864 -0165 FAX November 23, 1998 Enclosed is our submission for the repair of the sewage disposal system for the Owen Residence located at Box 387, Route 292 in Town of Patterson. As you are aware, the current system is failing and endangering the stream. The owner has retained our office to design a suitable subsurface disposal system. The disposal area. is constrained by the property lines high groundwater and the adjacent stream. On November 18, 1998, J&n1 Kalin of our office met with you at the site to examine existing conditions and discuss potential solutions to the failing system. At that time it was discussed and agreed that a fill system would be the most feasible solution to insuring adequate separation distance. All test data has been included on the plan to reflect the existing conditions observed. Based on information gathered in the field, a system was designed around the existing constraints. This design proposes a 1000 gallon concrete septic tank, and 200 lineal feet of 3 ft wide infiltrator trenches. We have chosen infiltrators for their increased storage capacity over conventional gravel and pipe system. A plan has been drafted and is included with this submission. We feel confident that this design will provide Mr. Owen with a safe, lasting design that will not compromise the stream and adjacent properties. Should you have any questions with the design, please contact John Kalin at your convenience. Very truly yours, GAINER - WILBUR CONSULTING ENGINEERS, P.C. RONALD J. G R, P.E. President RJG:lcg 112398.1tr PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES RE: Property of Located at LETTER OF AUTHORIZATION John L. Owen III Route 292 T/X Pnttarsnn Tax Map # 3.19 Block Subdivision of - Subdivision Lot # -- Gentlemen: Filed Map # 1 Lot 45 Date Filed -- This letter is to authorize Gainer- Wilbur Consulting Engineers, P.C. a duly licensed Professional Engineer X or Registered Architect to apply for the required wastewater treatment and/or water supply permit(s) to serve the above -noted property in accordance with the standards, rules or regulations as promulgated by the Public Health Director of the Putnam County Health Department, and to sign all necessary papers on my behalf in connection with this matter and to supervise the construction of said wastewater treatment and/or water supply systems in conformity with the provisions of Article 145 and/or 147 of the Education Law, the Public Health Law, and the Putnam County Sanitary Code. Very truly your . Countersigned: Signed:_ P.E., R.A., # a40 (own of Property) Mailing Address P.O. Box 417 Mailing Address: Kokosing Farm RR2, Box 387 Pawling State New York Zip Telephone: (914) 855 -1255 12564 Patterson State New York Telephone: ( 914 ) Zip 12563 Form LA -97 l ® SHED t' \ W tO SILT FENCE (TYP.) o M it j DEEP TEST (TYP.) `O uj SF LOPE z SF 50' o (TYP) � PVC PIPE (TYP) DT -3 fILTRATOR (TYP) CLAY BARRIER JCE ROVED P3 3' (MIN.) FILL SECTION ST. BOX D LEVELERS DT -2 � P1 (n DT -1 o ON CONC. JK 9' (Typ) 3 POOL ``' lo' (MIN) NDONED TIE INTO EXISTING GRADE i TIGHT n ) ° / CONNECTION ® SHED t' \