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00750
BRUCE R. FOLEY
Public Health Director
LORETTA MOLINARI R.N., M.S.N.
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, 'New York 10509
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
October 29, 2001
Dennis & Debbie Scofield
606 Farm to Market Rd.
Patterson NY 12563
Re: Addition- Scofield. -.606 Farm to Market Rd.
No Increases in Number of Bedrooms
(T) Patterson Tax # 24 =1 -32
Dear: Mr. & Mrs. Scofield:
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. form this
Department dated October 26, 2001 The addition is approved _with the following conditions:
1. The total number of bedrooms must remain at Three without prior approval
b thls de artment.
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 Patterson.
If you have any questions, please contact me at your convenience.
Very trulLy_yburs,_
William Hedges....-
WH:kg Senior Public Health Sanitarian
cc: BI
ro
BRUCE R. FOLEY. R.S
Acting Public Health Oire-t;;,
DEPARTMENT Of HEALTH
Division Of Environmental Health Services ,
4 Geneva Road, Brewster, New York 10509
(91�0 278 -6130
PROPOSED ADDITION APPLICATION _ (RESIDENTIAL O�JLY
STPcET:60(r, -%ti�'SA IY1I�tLES"AND TOY114 PAT��0N TX MAP r
Nk4, PHON_' i�� PCHO PERRMIT r ►! �}/
MILING ADORESS �O �P —tT P e0�
Description of Addition
Number of existing bedrooms Proposed number of bedrooms
from Certificate of Occupancy or
Certification from Building Inspector
A.ny addition which is considered a bedroot-ii requires formal approval of plans
(Construction Permit) prepared by a Professional Engineer or Registered Architect
in accordance with applicable sections of the Putn?rrii County Sanitary Code.
Please submit this forn and the following to PUTNA;'4 COUNTY HEALTH DEPARTMENT,
4 GENEVA ROAD, BRZISTER, NY 10509, Phone 278 -6130 with the following information.
1. Certified Check for $100.00.
2. Sketch of existing floor plan (all living area including basement, if any)
Non - professional dra -rring is acceptable.
3. Sketch of proposed floor plan.
Non. professional drawing is acceptable.
4. Copy of survey showing rrell and septic location, to the best of your
knowledge. Include date of installation if known.
Include all yells and septic systems within 200 feet of property line. Any
questions please contact this office.
5. Copy of Certificate of Occupancy iron Taem or Certification from Building
Department of legal bedroom count of dwelling.
OFFICE USE
Comments and /or conditions
application
August 1995
July 1995
DEPARTMENT OF HEALTH
Division ; 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
BRUCE R. FOLEY. R.S.
Acting Public .Health Director
Re: ' a f i s.-E)
Residence
Tax Map
Town FArTF-'6bo
Gentlemen:
According to records maintained by the Town, the above noted dwelling
IS
IS NOT "
in compliance with ToNN-n code and the total number of bedrooms on record
is_
This information has been obtained from:
- CERTIFICATE OF OCCUPANCY.
ASSESSORS RECORD: X
OTHER
ding Inspector �
a
V/
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
SITE LOCATION f
OWNER'S NAME ^. - k
MAILING ADDRESS Lo(� r&.r m 1-,
OFFICIAL USE ONLY
TM#
PHONE
// nn
PERSON INTERVIEWED 06.t-1;1V G ` — A 0* - PCHD Complaint #
ame a atlons Ip (i.e., owner, tenant, etc.
DATE �r� r ®� TYPE FACILITY.�,I� /e •�� �/_
PROPOSED INSTALLER n62e��M, PHONE f S'-a� -S� �' 0 3
ADDRESS t/ -j A" REGISTRATION #_ 1 Y
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 from licensed professional engineer or registered architect.
29
I, as owner, or re rted agent of owner agree to the conditions stated on this form.
SIGNATURE i''' TITLE �� DATE�rn� ^
Pro on sal aADroved 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 components tied to two fixed points (e.g.,house corners).
d. System description (e.g., 1250 gal. Concrete septic tank, three precast 6' diam. X 6' deep
e. Installers' name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
Proposal approved �.
Inspector's Signature & Title D16E
COPIES: White (PCHD); Yellow (Town BI); Pink (applicant)
PC -RP 99ML
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FRED ADAMS, JR. INC.
691 Farmers Mills Road
Carmel, New York 10512
(845- 225 -8123)
To PA A,>l .
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MW COUNTY DEPART)' " OF V&AkT8
HOUSE PLANS APPROVED TM
BEDROOM COUNT ONLY)
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:SCALE: APPAOVED'BY DRAWN
DATE: