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08/11/2010 10.28 8458782019 PATTERSON PLANNING PAGE 01/e3
SHERLITA AM LEK MA MS, FAAP
Commissioner oJ'Health
LORETTA MOLINARI, RN" MSN
Associate Commimlon¢r of Health
ROB
ROHERTh
DirQctor of Envi.
DEPARTMENT OF HEALTH
1 Genova Road. Brewster, New York 10509
ADDITaOIY APPICATION RUjQEWML ONLY
C./
STREET 1 TOWN TAX MAP #D
PHOIYE���H�� ri�8 pCHD# 16
MAILING
ADDRESS
DESCRIPTION OF
ADDITION W/7"r XIPAP MoD l-n off+
NUMBER OF EXISTING BEDROOMS 3 PROPOSED # OF BEDROOMS-
(FROM CERT, OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR)
"Any addition which, is wnsideted a borlroom 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 ealth Dept., 1 Geneva Rd,
Brewster, NY 10509, Phone: (845) 278 -6130.
1. Certified check or money order for $100.iDO.
2. Sketches of existing floor plan (drawn to scale, all living area Including basement, to be
shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin
HA -1)
I Two sets of proposed floor plans (draw-n -to scale_- with name, street and fax rna -
- - - - - IN1011- pffifIe ianal sketches are acceptable and preferred. (See Section 3.d of Bulletin
HA -1)
4.. Copy of survey showing all well and septic locations on the subject property to the beat
of your knowledge, Include date of installation known. Contact this office with any
questions.
5. Copy of Certificate of Occupancy from the Town or Certification from the Building
Department with legal bedroom count of dwelling.
OFFICE USE
COMMENTS
s. •
Envirmmental Health (845) 278.6130 Fax (845) 278 -7921
Water Supply Sectio0 (845) 225.5186 Fax (845) 225 -5418
Nursing Services (845) 278-6558 Fax (845) 278 -6026
Nursing Rome Caro Fax (845) 27$4085 WIC (845) 278.6678
Early intervention / Preeehool (845) 228 -2847 Fax (845) 225 -1580
uv, ii, cola tv: to ti47Yf lWlbly
PATTERSON PLANNING NAUt 10�1/0a
SHERLITAAMLEFt. NO, MS, FaA,P
C-ommirsiorer of Health
LORET Tai MOLi iVAR[, RX, MN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
I Geneva. Road. Brewster, New York 10509
ROBERT J. BOND1
Counly Executive
ROBERT MORRIS, PE
DmectorofEnvironmental Health
Togo Bedroom Cwmt & Pronased AdditioA StBtu�
Re, (owner's Name)
Tax Map # .M. p--
llddress: ��
Town:
Year Built:
According to records waintained by the Town, the above noted dwelling,
1s , in compliance with Town Code.
Is not it compliance with Town Cede.
The Legal Bedroom Count is: -: -3- .
This information has been obtained from:
Certiflcate of Occupancy:
_ - 4. her•. -
. --
The plans for the proposed addition are considered:
New Construction
Addition to existing house only
Teardown and/or re -build allowed under Town Regulations
Environmeatal Health (845) 278 -6130 Fax (845) 278 -7921
Water Supply Section (845)225-S186 Fax (845) 225.5418
Nursing 5crricea (845) 278 -6558 Fax (845) 278.6026
Nursing Homc Care Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention / Prewhool (845) 228 -2847 Fax (845) 225.1380
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Slherlita Amler, MD, MS, FAAP
Commissioner of Health
-
-Robert-Morris, PE- - - --- - -- - - - -- - - -.
Director of Environmental Health
R. Lichtenberger
P.O. Box 466
Brewster, NY 10509
Dear Mr. Lichtenberger:
Department ®f Health
1 Geneva Road, Brewster, NY 10509
Office (845) 808 -1390
Fax (845) 808 -1937 .
September 17, 2010
Re: Addition- Approval — Lichtenberger
No Increase in Number of Bedrooms
419 Haviland Drive
(T) Patterson, T.M. # 25.40 -1 -30
Robert J. Bondi
County Executive
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 the-Department
date September 17, 2010. 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.
_ - _ _ _- _ _ _ devices i e new low flush toilets
3. Ah:nlumbtng fixtures_ roust be updated with water saving . , _., ., _ _ _ ,^ _
restrictors for shower heads and faucets, etc.
4. The approval is for the proposed changes only. This approval does not validate any construction
shown as existing that has not obtained proper approvals.
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.
Respectfully,
oseph S. Paravati, Jr., PE
Environmental Engineer
JSP:kly
cc: BI, (T) Patterson.
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PUTNAM COUNTY
� rT OF HEALTH
'ROUSE PLAT YS APPROV h
COUNT. ONLY,
BEDROOMS A
ALL SUBSEQUENT REVISIONJALTERATIONS TO THESE HOUSE
P ANS MUST BE S BMITTlEI3 TO THE PCDOH FOR APPROVAL,
GNATURE & TITLE
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