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02663
6
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
APPLICATION TO CONSTRUCT A WATER WELL
,:..:pCHD'- Permit #' r Q
Well Location:
Street Address: Town/Village Tax Grid #
SI c14.4P AD PkTivjot t/Mu6 Map (p Block 4-- Lot(s) 2.
Well Owner:
Name:
Address:
STEP 14d IVES
140 SLOGu m M E-A[ t4 , NY 1%,4-69
Use of Well:
_X Residential Public Supply Air /Cond/Heat Pump Irrigation
rimary
Business Farm Test/Monitoring Other (specify)
2- secondary
Industrial Institutional Standby
Amount of Use
Yield Sought S —+ gpm # People Served __� _ Est. of Daily Usage _gal.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
New Supply (new dwelling) Deepen Existing Well
Detailed Reason
CX we-// w: // ,6e aw li,✓
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 �C
Name of subdivision Lot No.
Water Well Contractor: /1/e w/r Address:
Is Public Water Supply available to site? .................................. ............................... Yes No
Name of Public Water Supply: Town/Village
Distance to property from nearest water main: N/
Proposed well location & sources of contamination to be provided on separate sheet/plan.
Date: Applicant Signature: Fa
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 dril er certified by Putnam
County.
Date of Issue 00 Permit Iss 'ng Official:
Date of Expirationt G Z vex Title:
Permit is Non-Transferrable
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WP -97
�wucrp -c9 -vv &s:C`b STEPHEN W. COLEMAN 914 - 762 -5260 P.02
CHAPTER 044: Fmhwater Wetlaads, Wateneu ms anal Wzterl➢4mNes Ordinn nee of
the 7o wn or Putnam Valley, New IYo&
The Town Wetlands Inspector, as Approval Authority, has determined that the proposed action is
an Unlisted fiction under SEQRA, and will not have a significant environmental impact.
There%ne, a PERM 97 WAIVER is granted subject to the conditions noted below.
DATE PERMR11 USSUIR D:
DATE PERMIT EXPIRES:
APPLICANT/SPONSOR-
PROPERTY LOCATION
August 23, 2000
August 23, 2001
Stephen Ives
CA) Tnsignia films
41 Bond Street, Suite 400
New York, New York 10012
51 _ Chapman ]toad
TAX MAP #: 61 -1 -2 SIZE OF PAR CiFL: 5.08 acres ZOFARNG: R -3
PROPOSED ACTEON: Construdlum of an iaaldiQiuw, tempomry access road, well
wiThOn wetland buffer swea
MATERIALS, REVIEWED:
1. Application Materials, file # W r -305 and 361.
2. Site Plan for Stephen Ives do Anne Symntes, as prepared by B. Higley, L.A., dated 08-21 -
W.
3. Wetland Mitigation Plan for 51 Chapman Road as prepared by Anne Symntes, dated Off-
01 -00.
CUNIDIl'll'RONS OF PiFRMRT:
1. All construction shall fi,llowed approved Site flan as prepared by H. Higley, L.A., dated
08- 21 -00.
2. Wetlands Inspector to he notilled when erosion controls have been installed.
3. The; Building Inspector shall be notified once erosion control reassures are in place and at
Last 48 hours prior to the initiation of any site work.
Pope iof-2
Aug- ;dS -UU 23:24 STEPHEN W. COLEMAN
914 - 762 -5260
. 4. The Wetland Mitigation Plan to impleme_ nted. pri, r o, r, _t i. ssuance o.l. .Ccrtiicatc
of
Occupancy. 'i'lan to he inspected by Wetlands Inspector fiir compliance.
5. All wetland mitigation plantings to be guaranteed for two lull growing seasons. If any
materials die they shall be replaced at the beginning of the next growing season.
6. When Erosion controls are required, they must be maintained properly throughout the
construction process and remain in place until final site inspections lie' compliance with
conditions of permit have been' completed.
P.03
7. '1-he Planning Board, Wetlands inspector, and/or Building Inspector, shall have the right to
inspect the proicct from time to time.
8. The permit shall be prominently displayed at the project site during the undertak- ing of the
activities authorized by the permit.
9. An additional escrow account in the amount of S 300 must be established with the Town
before this Permit Waiver can be considered validated. `These additional escrow funds will
i.,e appmpriated as required for construction monitoring purposes. Any portion ol'the
account not used during the project monitoring period shall be returned to the applicant
upon satisfactory completion of the project.
Noncompliance with the conditions above will invalidate this Permit Waiver, and may result itt a
Notice of Violation and/fir a Stop Work Order. Any questions regarding this Permit Waiver
should be directed to the Town Wetlands insptector (914) 762- 7288, or the office of the Building
inspector (914) 526 -2377.
Date Permit Waiver Prepared: August 23, 2000
Stephen W. Coleman
Town Wetlands Inspector
cc: Applicant.
Building Inspector
Planning Roane
Environmental Commission
Page20f2
foamy- cs -¢,� Gj:Z4 STEPHEN W. COLEMAN 914 -752 -5260 P.01
STEPHEN W. COLEMAN
(hWhoing, New Mw* jew
FAX COVER MEMORANDUM
Date: 7.2s-00 Fax Number: 119 7'M0
Total Number of Pages = J Including this Cover Page
Hard Copy Will / Will Not Follow by Mail
To-
Prom: Stephen W. Coleman
Subject: _4
Message:
Phone: (914) 762-72M Far. (914) 762-9260
56 �t
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7 August 2000
Mr. Adam Stiebeling
Assistant Public Health Engineer
Putnam County Department of Health
1 Geneva Road
Brewster, N.Y. 10509
Dear Adam:
Pursuant to our conversation about our new well at 51 Chapman Road I am
enclosing the following:
• Three signed neighbor notification letters
• A copy of a section of our survey which shows the 200 foot perimter around
the proposed well and approximate locations of the adjoining property lines, as
well as the approximate location of the Hosay septic field, which is across the
road and more than.,100 feet from the well.
A money order for $100.00
I have been in contact with Steve Coleman and hope to have a wetlands waiver approved in
the next day or so. If it is allright, we will fax that to you as soon as it is available.
I hope that we can get approval for the well as soon as possible after our application is
complete.
Thanks very much for your help.
Sincerely yours,
9VL&�^
Stephen G. Ives za
rt
r
41 Bond Street, Suite 400, New York, NY 10012 Tel 212.979.5350 Fax 212.979.5368
25
APPENDIX E
Date
RE: Department of Health Review of Proposed
Sewage Treatment System for Property
Name: OW- P146:0 r- VIES *' '4W*E ��w•"`Ef
Address: 51 C )s4Pr'496,+ 0-49-A
Town: r/� "ILY
Tax Map #: &1-1-4
Dear P1a4 0 V
Please be advised that an application for a Construction Permit relative to the construction of a
sewage system and/or well proposed for the captioned property has been made to the Putnam County
Department of Health. Attached please find a copy of the latest site plan.
If you have any questions, concerns or information which may bear on the Health Department's
review of this application, you may call the Health Department at (914) 278 -6130.
Received By:
Address: �� 0404 a
Tax Map
August, 1999
AppndxE
Very truly yours,
By:
Title: 0141 k L ✓S
Sent-by: JOHN LANG INC. 212 584 2199; 08/07/00 13:08
p2tF9u X169; Page 1/1
Aec®Lved: 81 7/00 1Y:$l; 2129706368 -1 JOHN LANG INC,; Pago at
06/01/1996 22:3, 2129795368 IN51GNIA FILMS PAGE 02
r
25
APPENDIX E°
Date -o
RE, Department of HWth Revim, of Proposed
Sewage Treatment System for property
Name: 1'Fd5Pa&dF6V r-053
Address: 99
Town, Ai%Aoa, v 4°Y
T&xNUp #:
A Z ��M
Please be advised that as application for a Construction Permit relative to the construction of a
sewage system and/or well proposed for the captioned property has been shade to the Putnam County
Dc'pwtment of Health. Atwhed please find a copy of the latest site plan.
..:.,.. -... _.....1066 1,aV Ca6y tpae56.oIas; concaris or information whidh•miaytbear on the Health Depertrzion, s
review of this application, you may call the Health Npartmnt at (914) 27"130.
Very truly yours,
By:
I:eived y:
Address:
Tax Map 10: 61 ' 9 "2'
August. 1999
AppadxE
25 '
APPENDIX E
Date D ; J- „
RE: Department of Health Review of Proposed
Sewage Treatment System for Property
Name: S- f6PK+F*J E- VG3 J 4 N#E 'W$"&ft ES
Address: 5I Ckr'+ Ror-A
Town: 05..4%4,oft V•.044 -y
Tax Map #: GI -1-4
Dear
Please be advised that an application for a Construction Permit relative to the construction of a
sewage system and/or 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:.
Title: O'��/H ��✓S
Received By: Q�
Address: �ii C�r•.�w..�SdQ.,
Tax Map #: (/
August, 1999
AppndxE
✓`.. ...^.,�� � lid,
23 May 2000
Mr. Bill Hedges
Department of Health
Putnam County New York
1 Geneva Road
Brewster, N.Y. 10509
Re: Ives /Symmes addition -51 Chapman Road
Putnam Valley Tax # 61 -1 -2
Dear Bill:
Thanks for talking over the well situation with me the other day. It looks like we
are going to have to give up on the relatively new well that exists on the property because
it is under the new addition's kitchen. We walked the site with our contractor and with
Norman Anderson, who is going to drill the well for us, and we chose a spot in the
pasture. I.have marked it on the copy of the survey, thatjs, enclosed _ --
The new well is approximately 80 feet from the existing septic tank and much
further away from the tank than the well we are replacing. I hope this location is
acceptable because with the amount of rock on our property we are already looking at a
major expense to get the new well and the trench for the line to the house dug.
Please let me know if this application is acceptable or if there is anything else I
can provide. Thanks for your help.
Best Regards,
Stephen G. Ives
IC eE 141d S AN Go
1�t, l.dt,i
41 Bond Street, Suite 400, New York, NY 10012 Tel 212.979.5350 Fax 212.979.5368
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53271.56 •w
BRUCE R. FOLEY
Public Health..D,irector _ j
LORETTA MOLINARI .N.,. M.S.N.
Associate `Public "Health Director
Director of Patient Services
DEPARTMENT OF B EEALT H
1 Geneva Road
Brewster, New York 10509
Environmental Health (914) 278 - 6130 Fax (914) 278-7921
Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 . Fax (914) 278 - 6085 0
Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648
May 26, 2000
Steve Ives
Insignia Films
41 Bond Street, Suite 400
New York, New York 10012
Re: Ives Symmes Addition
51 Chapman Road
TM# 61 -1 -2, Town of Putnam Valley
Dear Mr. Ives:
This office has received an application to construct a "new" water supply well on the above
referenced lot on May 25, 2000. It is the determination of this office that the application as
received, is incomplete.
Please find enclosed "Procedure for New Well Permit Application ", dated August 1999.
Review of partial site plan indicates a "Wetlands Permit" will be required from the Town of. �.•
:.....,....: :.Putnam Valley to- underta work within 100'.0" buffer of wetlands prior to approvals of this
offi ce.
This office will continue its review upon consideration of the above mentioned comments.
Please feel free to contact me at ext. 2157 if any questions arise.
ABS:cj
encl. Well'Procedures
cc: Bill Hedges
Kathy Graap
ri
Very truly yours,
Adam B. Stiebeling
Assistant Public Health Engineer
P
b;
N SA
9 May 2001
Mr. Bill Hedges
D;,jiaitmetat of IIealth -
Putnam County New York
1 Geneva Road
Brewster, N.Y. 10509
Re: Ives /Symmes addition -51 Chapman Road
Putnam Valley Tax # 61 -1 -2
Dear Bill:
Enclosed please find a copy of our well completion report. Please let me know if
there is anything else that you require.
Best Regards,
Stephen G. Ives
41 Bond Street, Suite 400, New York, NY 10012 Tel 212.979.5350 Fax 212.979.5368
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL 1El[IEALT]HI SERVICES
' WELL COMPLETION REPORT
Fell L,oeatioirr r`= .trCetidiessj
�,�y�� p_
wn/Village: "
Tax Grid '.-#- ` 41-3 --- dd
Map // Block / Lot(s) �--
Well Owner:
e. Ad s
- 1U
Use of Well:
I- primary
2- secondary
esidential Public Supply Air cond /heat pump I igation
Business Farm Test/monitoring Other(specify)
Industrial Institutional Standby
)(Drilling ]Equipment
Rotary Cable percussion Compressed air percussion Other (specify)
Well Type
Screened Open end casing Open hole in bedrock Other
Casing Details
Total length 7-/ ft.
Length below grade ft.
Diameter G`� in.
Weight per foot /�lb /ft.
Materials: _x Steel _ Plastic _ Other
Joints: _ Welded X Threaded _ Other
Seal: >Z Cement grout _ Bentonite Other
Drive shoe: Yes No
Liner _ 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 Pumped Compressed
Air
Houra
Yield ICJ gpm
Depth Data
Measure from land surface- static (specify ft)
During yield test(ft)
Depth of completed well in feet
Well Log
If more detailed
information
descriptions or
sieve analyses .
ai e' available,
please attach.
Depth From
Surface
Water
Bearing
Well
Diameteron)
]Formation
Description
ft.
ft.
Land Surface
ell
If yield was tested
at different depths
during drilling,
list:
Feet
Gallons Per Minute
Pump /Storage Tank Information
Pump Type � Capacity
Depth A Model SS'oS -i3
Voltage 2Yo HP
Tank Type Volume
Date Well ompleted
3d 0 17
Putnam County Certification No.
1
Date of Report
5// ; �' A
II Driller (signature)
0 - ea
ldur: tpct location of wets wim atstances to at least two permanent ianarrtarxs to ne provtaea on a separate sneetipian. / % /q(�f
Well Driller 's Name "� �-n Address: /. �'` l
Signature: �¢ . Date: / 2 Z /
White copy: HD File; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WC -97
o�
BRUCE R. FOLEY
r L � ORETTA MOLINARI RN., M.S.N.
Public Health Director
^LY�� Associate !Pu is ' I{eQ irector. ,
`Tirector° of Patienl Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (914) 278 - 6130 Faz (914) 278 - 7921
Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085
Early Intervention (914) 278 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648
December 29, 1999
Steven Ives
Re: Addition- Ives /Symmos -51 Chapman Rd.
No Increases in Number of Bedrooms.
(T) Putnam Valley Tax # 61 -1 -2
Dear Mr. Ives:
I have received and reviewed the revised plans for the proposed addition to the above - mentioned
residence. The proposal for the addition has been approved as per plans bearing the approval
stamp form this Department dated December 29� 1999 The addition is approved with the
following conditions:
1. The total number of bedrooms must remain at Three without prior approval
by this department. _ . ..... _ ......._ _..._.
.2. The area of the existing. sewage disposal system, and its expansion area, must be
maintained.
3. All plumbing fixtures must be updated with' water saving devices, i.e., new low
flush toilets, restrictors for shower heads and faucets, etc.
Any other permits or variances required are the responsibility of the applicant and the jurisdiction
of the Town of Putnam Valley.
If you have any questions, please contact meat your convenience.
Very truly urs���r _........
William Hedges
WH:kg Senior Public Health Sanitarian
cc:BI
I 'VA 14 iNbiUNIA FILMS PAGE 02
RKS4GRIA I L M S
Mr. Bill Hedges
Department of Health
Putnam County New York
I Geneva Road
arewst", N.Y. 10509.
17 D=wbzr'l9.99
Re: lves/Symmsaddidon-5lChqmmRoad
Putnam Valley Tim 8161 -1 -2
Dear Bill:
Thanks very much for mecting with me on Tuesday regarding our plans for the
house on Chapman Road. I am attaching a copy of the plan we reviewed together, and a
revised plan which I hope nkliesses; your concerns: about the family mom Specifically we
have done the following:.
• Eliminated the hall bath -and made it a private bath inside the sewnd b .
• Reduced the. size. of the -family ;room from 154 sq. ft to 143 sq. ft.
Obviously then is 9 trade-off between shfinidog the f-h-mily mom so that it is
impractical as a bedmom. while .still leaving enou gh 5)ace so that it is functional as a family
room or den. We hope that by cutting the room off fwm'amess to a Wdmm and .
sbdxddng it somewhat we have awomplished these geds. Please feel free to give a call
at anytim if we need to dmuss. ft Awl=
apprc&te your wi ss to work out, a solution with us.
Best Regards,
Stephen G. Ives
270 Lafayette Street, Sulite.902, New York, NY 10012 Tel 212-274-0096 Fax 212-274.0 . 171
gAC,C li�i,�I_ TRAN4M>;54y N
DT: December-1711999. .
TO: Mr. Bill Red®es.
Department of Health.
Putnaat. County New .York
1 Geneva: Road
Brewster, N.Y. 10.509
FX: 914 - 270 -101
FR: Stephen Ives
RE: 51 Chapmaa Road -2nd floor floor ;-play revision
Number of .pages including this. cover'(4) . If you have trouble receiving this
transmission please caU: 212. 2740096.
270 Lafayette Street, Sulte'90i, New York, NY 10012 Tel 212.274.0096 Fax 212.274.0171
BRUCE � R_-,- _F:OLEY :, :..:: �.::.:
Public Health Director
Stephen Ives
70 Slocum Rd.
Beacon NY 12508
Dear Mr. Ives:
DEPARTMENT OF
1 Geneva Road
Brewster, New York
r -LORET -A 7. MOLINARI R.N., MiS.N. -
Associate Public Health Director
Director of Patient Services
10509
Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921
Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085
Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 July 13, 1999
wIC (914) 278 - 6678 Fax (914) 278 - 6085
Re: Addition- Ives /Symmes- 51 Chapman Rd.
No Increases in Number of Bedrooms
(T) Putnam Valley Tax 9 61 -1 -2
I have received and reviewed the revised plans for the proposed addition to the above - mentioned
residence. The proposal for the addition has been approved as per plans bearing the approval
stamp from this Department dated July 13. 1999, he addition is approved with the following
conditions:
1. The total number of bedrooms must remain at Three without prior approval by
this department.
2. The area of the existing,sewage disposal system, and its expansion area, must be
maintained:
3. All plumbing fixtures must be updated with water saving devices, i.e., new low
flush toilets, restrictors for shower heads and faucets, etc.
4. The two home occupation offices are not for bedroom use.
Any other permits or variances required are the responsibility of the applicant and the jurisdiction
of the Town of Putnam Valley.
If you have any questions, please contact me at your convenience.
ML:kg
cc:BI
Very truly yours,
i�
Michael Luke
Public Health Technician
BRUCE R. FOLEY
Public Health , Director
Stephen Ives
70 Slocum Rd.
Beacon NY 12508
Dear Mr. Ives:
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI RN., M.S.N.
Associate Public Health Director.
Director of Patient Services
Environmental Health (914) 278 - 6130 Fax (914) 278 - 7921
Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085
Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 June 25, 1999
WIC (914) 278 - 6678 Fax (914) 278 - 6085
Re: Addition- Ives /Symmes- 51 Chapman Rd.
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 61 -1 -2
I have received and reviewed the plans for the proposed addition to the above - mentioned
residence. The proposal for the addition has been approved as per plans bearing the approval
stamp from this Department dated June 25, 1999, he addition is approved with the following
conditions:
The total number of bedrooms must remain atjhr6e without prior approval by
this department.
The area of the existing sewage disposal system, and its expansion area, must be
maintained.
All plumbing fixtur'es'-must-be updated with-wateir saving 'devices,"i.e'.; new low
flush toilets, restrictors for shower heads and faucets, etc.
The two home occupation offices are not for bedroom use.,
Any other permits or variances required are the responsibility of the applicant and the jurisdiction
of the Town of Putnam Vallev.
If you have any questions, please contact me at your convenience.
Very truly yours,
Michael Luke
ML:kg Public Health Technician
cc: BI
1.
2.
4.
The total number of bedrooms must remain atjhr6e without prior approval by
this department.
The area of the existing sewage disposal system, and its expansion area, must be
maintained.
All plumbing fixtur'es'-must-be updated with-wateir saving 'devices,"i.e'.; new low
flush toilets, restrictors for shower heads and faucets, etc.
The two home occupation offices are not for bedroom use.,
Any other permits or variances required are the responsibility of the applicant and the jurisdiction
of the Town of Putnam Vallev.
If you have any questions, please contact me at your convenience.
Very truly yours,
Michael Luke
ML:kg Public Health Technician
cc: BI
BRUCE R. FOLEY
,,,Public. Health _.Directpr;_
DEPARTMENT OF HEALTH
Division of Environmental Wealth Services
4 Geneva Road
Brewster, New .York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET O�ECA"k AA. TOWN Pdfc_,�dTX MAP #.- (V-9-2�
m I <<, 4,x11&l s
NAME�fAES j!l1daNaVaU PHONE$ 04-00 ` PCHD# 1�1,7-347
MAILING DD•�(�
DESCRIPTION OF ADDITION .,
NUMBER OF EXISTING BEDROOMS 3 PROPOSED # OF BEDROOMS �
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM BUILDING INSPECTOR)
*Any addition which is considered a bedroom requires formal approval of plans (Construction
Permit) prepared by a Professional Engineer or Registered Architect in accordance with
applicable sections of the Putnam County Sanitary Code.
Please submit this form and the following to-Putnam County Health Dept.,4 Geneva °Rd:,
Brewster, NY 10509, Phone 278 -6130.
1. Certified check or money order for $100.00
2. Sketches of existing floor plan (drawn to scale, all Hiving area including basement)
* Non - professional sketches are acceptable
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
* Non - professional sketches are acceptable
4. Copy of survey showing well and septic location, to the best of your knowledge. Include date
of installation if known. Label all wells and septic systems within 200 feet of the property line.
Contact this office with any questions.
5. Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
OFFICE USE
Comments
Feb 98
} BRUCE R, FOLEY, R.S.~ ^
Acting Public ,Health Director
DEPARTMENT OF HEALTH
Division ti Of Environmental : Health Services
4 Geneva' Road, Brewster, New York 10509
(914) 278 -6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Re:
Residence
Tax Map 5-1 - 1 -
Town ?WN vru-LF`{
Gentlemen:
According to records maintained by the Town, the above noted dwelling
IS �
IS NOT
in compliance with Town code and the total number of bedrooms on record
is vv� lkraNt 3 cdvwtr" 40 2
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD: V/
OTHER
51-z 9rl99
Building Inspector
)9S
10
)F PUTMA°9 TOXIN LIB ccf z
'PUTNAl VALLEY
• * ** PROPERTY.DESCRIPTION REPORT **
REPORT IS FOR YOUR.INFORMATIOM. IT SHOWS IMPORTANT DATA 4HICH
3EEN COLLECTED FOR YOUR 9ROPERTY.
THE INF07MATION IS CORRECT. KEEP THIS REPORT. IF CORRECTIOMS
E REQUIRED 3EC4USE OF INCORRECT OR +MISSING DATA. PLEASE MAKE THE
PROPRIATE CORRECTIONS % RETURN THE REPORT.WITHIN 5.DAYS OF RECEIPT.
MACEDO 3AR3ARA A I ROBERT
RD9 3OX 374
CHAPMAN ROAD
GARRISON MY 90524
****;*** tkik*irA ***Ara6**0?, rck4, *itt4dt***
*** PROPERTY DATA * *�
3PERTY ID 3125570 690 °9 °2 HN
3PE.RTY LOCATION 59 CH A.tel_R.II___,
)PERTY DUME.4S.IOMS 4.31 ACRE S) -
CRES \oe %rCo4Veu�
3OOL DISTRICT 37250
:ASE VERIFY.SALE INFOR9ATIDN IF YOUR PROPERTY HAS SOLD SINCE
SALE DATE
SALE PRICE
fE NO. 09 TYPE OF ENTRY
)PERTY TYPE 260 SEASONAL RE.S ZONING
BILABLE !ITII ITT CC ELECTRIC
09192:
NO ENTRY
CD
DER SJPPLY PRIVATE
'E OF SERER PRIVATE
_. _. RE: S :I.D.E.�CE.,.D,A.T.A._._.._.... ..._.
[LDING STYLE OLD STYL:f YEAR BUILT 9920
rERIOR WALL WOOD - SQ. FT. LIVING AREA 937
;EMENT TYPE CRAWL N� 1"J � NO. BATHROOMS 9.0
°E OF HEAT e,V NO. BEDROOMS
°E OF FUEL ail!.— MO. FIREPLACES 0
ITRAL AIR 10
°ROVEMElTS DIMENSIONS 3UILT �aUANTITY
GARa9.0 DET 20 X 98. 9a4o 9
THE TYPE OF ENTRY SgOW4 43OVE IS AN ESTIMATE OR A REFUSALc, YOU HAVE
OPTION OF AN INSPECTION. TO EXERCISE THIS OPTION IINDICATE BY.
CKING THE 30X LA3EL.ED "INSPECTION" 3ELOW. BE SURE TO INDICATE A
TINE PHONE 4. JE 'BILL CO'IFACT YOU. BE AWARE THAT THERE MAY BE OTHER
A ITE"IS THAT HAVE BEE19 COLLECTED FOR YOUR PROPERTY WHICH ARE NOT
LUDED OM THIS REPORT. IF CORRECTIONS HAVE BEEN MADE. PLEASE SIGN
DATE 3ELOdo AMD lAIL THIS DOCUMENT-TO THE FOLL WING'ADDRESS:
COLE% LAYER °TRUMBLE CO SIGMATUREo� av "ao m� �L�me
929 IAIM STREET ° ° °'� "a
BREklSTERo M.Y 10509 PHONE # ° ° C-1 ' � ° np�'1�q
C ] INSPECTION e 40T DATE
NECESSA3Y FDA COADOS ° ° ° ° °°
r
_
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PUTNAM COUNTY DEPARTMENT OF HEALTH/ z -
DIVISION OF ENVIRONMENTAL HEALTIf SERVICES
INITIAL 1NDIVUDAL ADDITION/REPAIR FORM
SECTION A: GENERAL INFORMATION
Name of Project —(T )(V) TM#
Year of Construction Size of Parcel
SECTION "B. TOPOGRAPHY (Please check all appropriate boxes)
1. ❑Hilly ❑Rolling []Steep Slope UGentle Slope ❑Flat
2. . ❑Evidence of wetland []Low area subject to flooding ❑Bodies of water
13D.
Drainage ditches Rock outcrop
S NO
3. Property lines evident? ❑
4. Water courses exist on, or adjacent to parcel: ❑
5. Existing individual wells within 200ft of the existing SSTS? l ❑
SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS)
1. Physical character of existing SSTS area. .
A. ❑Level UGentle Slope ❑Stee P slope
e
��
B. ❑Well drained (7 Moderately well drained
[]Somewhat poorly drained ❑Poorly drained
C. Area available for SSTS. (Primary & Reserve) �� —
❑Extremely limited ❑Somewhat limited L�A�� dequate ft x ft
D. INSPECTION Date Z Inspectors
Ll K o evidence of failure []Evidence of failure ®Evidence of seasonal failure
------------------------ -- --
(Indicate ,North)
A d"
N
n
(1) Indicate location of SSTS
POO
Ll
A. Size and type of septic tank gallons
��4eta1
Cloncrete.
Chlastic
B. Type of absorption area
1. Fields ft. 2. Pits 3. Gallies
a
(2) Indicate setbacks, front street, backyard, and side yard dimensions
(3) Show location of well
(4) Show location of driveway
(5) Note physical features (steep slopes, rock outcrops, streams /wetlands)
SECTION E. EXISTING WATER SUPPLY
CIPWS MShared well 13'Individual well
®Drilled ug masing above ground
CONRvIENTS : c f e ✓��. �-f' �nr� ��
REPAIRS ONLY: Status:
As Built Inspection Required:
As Built Inspection Done:
As Built Submitted:
Inspector:
'FROM : NAUSHON FARM
|_
PHONE NO. : 1 508 299 6048
,
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Jul. 13 1999 01:36PM P1
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PUTNAM COUNTY DEPARTMENT
HOUSE PLANIS, APPROVED FOR
BEDR001M COUNT ONLY;
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Signature &Title . .... .
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ANDREW CHARY
ARCHITECTS
460 OLD Wff BOAR, P.O. BOX Z% BOTORD, N. Y. IM ML %UMZB FAX' SUMMU &ma&lylm lw,,hMm
DAN: SCAM RNSM:
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DAN: SCAM RNSM:
IVES/S-NES 12/5/clq /4
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PUTNAM COUNTY 0 PARTMENT OF HEALTH
HOUSE PLANS APPROVE FOR
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07/08/1999 11:53 212 - 941 -6898 INSIGNIA FILMS PAGE 01
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�._ �NSIGN-1A....F -i, ms
Facsimile Transmission
DT:
July 8, 1999
TO
Mr. Mike Luke
Public Health Technician
Putnam County Deparbnent of Health
1 Geneva Road
Brewster, N.Y. 10509
`•.
�y facsimile• 414-278 -7921
PR:
Stephen Ives
RE:
Revised Boor Plan -- 51 Chapman Road
Number of pages, including this one ( 8 ). If there is a problem with this
transmission please call Stephen Ives at 914 - 831 -1142.
Insignia Films
270 Lafayette Street, Suite 902, New York, N.Y. 10012
212 - 274 -00% Tel,
07/08/1999 11:53 212 - 941 -6898 INSIGNIA FILMS PAGE 02
atepbeo 9705 trend Amme SYMMG9
70 Slocum Rood
seacomp N.Y. 1250
9n.6-330-6270
July 8,1%9
Mr. Mike Luke
Public Health Technician
Putnam County Department of Health
I vas Road
Brewster, N.Y. 10509
Thmks very match for speaking with me yesterday regarding our subanission of a
rev ind floor plan ffor our proposd addatmoa at 51 Chelan RwA
We have been wo&q with the Wedan& Ins from Putnam Valley to devise u
f ng for the house Haag mnmanM—Zes our incursion into the wetlands area,. As you will
enstin� can Into l e a=
bedroom aMtion was .hilt at a right aangle to the cabin, connemd by a coMdor.
UsfaUnakly, this daigma (Wavle the most eon eff®etive) pzhad dw cedp of the base too
far to do south and too dam, to the of the wdl3D&.
In order to solve this p Mem, we hired an architect who came up with a plan to
umqxvale the cabin into the new addition, and theca build a one- and- a•halff story baana
by a bid8e, iWng dw rmk pale twat to the hour as a fm . This
approach stllI gives us the bo mae office, space we need, as well as some much needed
stage, b=eg naitW rite existing cabin nor the addition VAR kwon a bmwent
07/08/1999 11:53 212 -941 -6898 INSIGNIA FILMS PAGE 03
Stephen Ives and Anne Symmes
70 Slocum Road
Beacon, N.Y. 12508
If there is a chance that you and ,Bill can review this on Monday or Tuesday of next
week, it would do wonders for our chances of making the zoning board deadline of
Thursday, July 15th. If this revised floor plan is approved, we will need to pick up the
anginal and include it with our zoning application, and I will keep in touch by phone to try
and cootdinate this.
Many thanks for all your kelp. I will be out of town this week, but you can teach
me at 508- 299- 80'32. I am afraid there is no answering machine, but you can always leave
a message at my Manhattan office, 212- 2740096.
Sincerely yours,
Stephen Ives
07/08/1999 11:53 212-941-6898
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07/08/1999 11:53 212-941-6898
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