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631- 589 -8100
25.47 -239
BOX 11
01030
ME
2
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01030
BRUCE R. -FOLEY
Public Health Director
Anthony Imbo
360 Haviland Dr.
Patterson, NY 12563
Dear Mr. Imbo:
DEPARTMENT 'OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORETTA MOLINARI •R.N., 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
WIC (914) 278 - 6678 Fax (914) 278 - 6085
'March 18, 1999
Re: Addition- Imbo- Haviland Dr..
No Increases in Number of Bedrooms
(T) Patterson Tax # 25.47 -2 -39
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 March 18, 1999 The addition is approved with the following
conditions.
of bedrooms must'renlain at3'wo without prior
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' Patterson.
If you have any questions, please contact me at your convenience.
Very truly y_Qurs, .
G�
William Hedges
WH :kg Senior Public Health Sanitarian
cc:BI
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INITIAL INDIVIDUAL ADDITION / REPAIR FORM
SECTION A. GENERAL INFORMATION
Name of ProjJ ect 0 av-tja.J Or TM#
(�(V)
Year of Construction Size of Parcel
SECTION B. TOPOGRAPHY (Please check all appropriate boxes)
1. alilly DIR"olling n.eepislope nentle slope ,Flat
2. OEvidence of wetlands OLow areas subject to flooding w OBodi . oftwater
Mrainage ditches l_'7Rock outcrops
r.
3. Property lines evident? O
- - ~-- 4.-- Water courses-exist -on, or adjacent to parcel? -._ .v_..-� ..I . • - L_W"
S. Existing individual wells within 200ft of the existing SSTS? U' O
SECTION C.. EXISTING SUBSURFACE SEWAGE,TREATMENT SYSTEM (SSTS)
1. Physical character of existing SSTS area.
A., OLe v*el (�Gentle'glope ❑Stee slope
B. OWell, drained C well drained
OSome what poorly drained ,Poorly drained
C. Area available for SSTS. (Primary & Reserve)
DExtremely ite ClSomewhat limited ClAdequate ft x ft
lured
A
b ma-
-------------------------------------------------------
1 Indicate location of SSTS
A. Size and type of septic tank gallons
OMetal OConcrete OPlastic,
B. Type of absorption area.
J.' Fields `'ft. 2. Pits 3. Gallies ft.
(2) Indicate- setbacks, front street, backyard,. and side yard dimensions
_'__ _(3) 61W,4ocafion of well
(4) Show1ocation of driveway
(5) Note =physical features (steep slopes, rock outcrops) streams /wetlands)
SECTION E.. 'EXISTING WATER SUPPLY
OPWS 13 Shared well Individual well
Drilled Dug ittc.L . ' above ground
g g
COMMENTS
20'- o'
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DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
ADDITION APPLICATION _ (RESIDENTIAL ONLY
BRUCE R. FOLEY, R.S.
Acting Public Health Director
STREET: /My /L/,I Vn az TOWN PV n*716W TX MAP # 3_725 fQ0
NAME: Aloyalo" 4M, 60 PHONE `l /5����tf/Cu� PCHD PERMIT #
MAILING ADDRESS 360 A,)a -40 ,J' 9/C ��/�5�.✓ , zV
Description of Addition 61111*(Ifi,� ar iSTi < 5
Number of existing bedrooms_ Proposed number of bedrooms
Any addition which is considered a bedroom requires formal approval of plans
(Construction Permit) prepared by a Professional Engineer or Registered Architec.
in accordance with applicable sections of the Putnam County Sanitary Code.
Please submit this form and the following to PUTNAM COUNTY HEALTH DEPARTMENT,
4 GENEVA ROAD, BREWSTER, 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 drawing is acceptable.
3. Sketch of proposed floor plan.
Non professional drawing is" acceptable.
4. Copy of survey showing well and septic location, to the best of your
knowledge. Include date of installation if known.
Include all wells and septic systems within 200 feet of property line. Any
questions please contact this office.
OFFICE USE
Comments and /or conditions
application
August 1995
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August 1995
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This is to c @`tify that I have surveyed B E N D ,E V I H 0
LOT5 5142 5143 5144-45145 LAND sutivErows
10 PIBKG PLACE -
' "SEI�ENTH M /POP Pl/TNAM LAKE a MT. VERNON. N. V.
ROOM 106
TOWN OF PAT,rERS0N COUNTY OF PUTNAM /VE.V YORKT«.,.V-1.c NO a -0eeo
4 Filed In the PUTt" County Clerk's Office Division of land Records A-C MOP A/n. /49 F
I have located all existing buildings and lines of possession and have shown their positions hereon.
I hereby cultity this surrey. to .COMMONWEALTH LAND, 71TLE..iN51JRANCE CCQ.O1= NFJN YbRKn
Survey unntdeted: 831 70 on scale of one inch to 16 feet.' �llit�il� .IGY�
Map dialled: 9 -I 70 N.rs. 1H 7080 '
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