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Home My WebLink About1033DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.47 -2 -47 BOX 11 .. 1 1 6 1 ', ` r� H,' , ��I ., r 1 'I 1 u Ed T tiE Is My �¢ h L1 ` i -W4 1. 01033 :SIiERLITA AMLER, MD, MS, FAAP Commissioner of Health - LORETTA MOLINARi; RN-,-MSN - Associate Commissioner of Health ROBERT J. BONDI n County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ADDITION APPLICATION RESIDENTIAL ONLY STREE ME MAILING ADDRESS DESCRIPTIOA6 ,jd NUMBER O EXISTING BEDROOMS 6;2- 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., 1 Geneva Rd, Brewster, NY 10509, Phone: (845) 278 -6130. - - 1. Certified check or money order for $100.00. 2. Sketches of existing floor plan (drawn to scale, all living area including basement) 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 locations 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 Certificate -of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE COMMENTS Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 Early Iaterventiow?reschool (845)278 -6014 Fax (845) 278 -6648 FROM :CAHOUSTON FAX NO. :845 279 7751 Jan. 10 2006 09 :40AM P2 1557°cg;•av> \119 ��54 G_r52. e-14,1 u t u.'d -A. -Ca;E @Z -tiro' 4 t� N, �azsr �xxl�l / lOt.t'1' • :J rr POO Fag' c_ t> G.t74 ^- - SlJ••r °C� �Crv'� 4�s.G5' ei C, MA tAp cs%� 169 rec C'� h'1bv 1'-�iOiCrt GtG 20 t 10 Y i I� f/ .. c'+ it •.a-,.' -,mTq-m t. Nx�e•d..tt � G G. •r�t',e.�i•1pr.Ys n.: nr .�'�.:. .,F aar�.' Cli6t.l.r� . :...:' t 4d1,.rttrnQt ZEa ,1,c7! . t r, <t: c.L' st f !.' e , • • 'e t: 2vE ! VuA6 VVA- M.Q'F_ n tU AC "nt .f uu t ..o. 'trll'r. d4 AUP Ma A. f M4 AL V.- 1.,' rt �.+�F: r real e_xiS7rr.Ya er3e *_ .SC' t stLTK2 Fte L.",;. :. 0'%,P- r. ' -^201L -rf r-AP LA 14 `Mv• r'rltre et•. .4 fMa t rRBLZ, @-e rkc U6 k/ Nlw t •611t7p.. ~,C!e*i&l ry wl . a, 4dit.. 4+M • l! to . 4 tied e`YrP,)rA4A—, % A&fts 4C.C.p_�-Cw,. 4At r. rr:.g3Ick'/tf t►r, Wr ,Kj 4um Ad.l r.Gt'r't rot Cop •itticAj w:. eta pA, ut .,Wt 6K f-v `eAl � i w-4 , C.. ?ira • AL. rG g1prcc. ful-7 l� e,, u.. C :ywEFj t•�lF =1 r5 •PQEyi�l. ,at,ti�dittiltt� tE.tt4rt t:t lrr� tyl� j r4.0f u'OtAcr MApc %-.'c,r�,••a f C_#Ag'AAN .AUt -j, L CgOdL16 *f.jMl"r1 r 7F;. PC-AV- IVA: t,Ar *'CeEr.* -* -I FAt:f t,te C *ZrjMC iftcn r. /Y1: LO 't wt iScr-- r.4M' c - ,.L'N.•r.¢..ruje 4..c,► a±s-ASN". ttam:4t rr.t�rrtt,tttt ,%J4 cw 6L*56E.m�.tl-►t ,:+,,rfzi+; pc C0.93a e ! �tflu i %-tt -t ! .. p�?. itFY,l\ LY_: h•F. _.!&t tl^J:�tr �:�:� '4 R. 10 Y i I� f/ SHERLITA AMLER, MD, MS, FAAP _Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI CountyExecutive Town Legal Bedroom Count Re: (Owner's'Name) Tax Map #: Address: Town: Year Built: ' /' y According to records maintained by the Town, the above noted dwelling, is in compliance with Town Code. . is not in compliance with Town Code. . _. •The Legal Bedroom" mJ2ount is: This information has been obtained from: Certificate of Occupancy: Other: Building ecto J Date Environmental Health. (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 SITE K IQ I - 3 PHONE 79 -3Z8� 74# 57 -5--? S - s -/o MAILING ADDRESS PERSON INTERVIEWED PCHD Complaint . > Name & Relationship (i.e,.owner, tenant etc.) DATE (o/ a31 TYPE FACILITY PROPOSED INSTALLER i�.Lti'LA�t•% D',(9. PHONE 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. i i Proposal approved Proposal Disapproved Inspector's Signature & Title r000sal aoaroved with the followinct 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 d. System description (e.g., 1250 gal. concrete septic tank, drywells surrounded by one foot + gravel). "e. Installer's name and number. c Da (e.g.,house corners). three precast 6' diem. x 6' deep 3. System repair to be performed in accordance with the above proposal and conditions. I, as owner, or repor get owner agree to the above conditions. SIGNATURE TITLE O4/ j2A,- DATE 1.2 OPHS: `lute (POGD); (Mm HE); Pink (AFpliamit) BURDICK CONTRACTING, LTD. E S T- I MATE Sager Road BREWSTER, NEW YORK. 10500 (914) 279.4152 To IM rS O v %4- p rx _ DATE -JOB No. - - -- NAME X _�5 5.9 /52 S �� a JOB LOCATION - xA _ - �dwn aT Pmi+ersor- Rep0.i.r _ 1G3 -4`i DESCRIPTION PRICE AMOUNT �onKefs �-a o� d . .. , 1 SHERLITA AMLER, MD, MS, FAAP la .e1 ROBERT J. BONDI -° Commissioner-of-Health " - * *� . County Executive LORETTA MOLINARI, RN, MSN Associate Commissioner of Health July 18, 2006 Brian McLoughlin 5 Yonkers Place Patterson, NY 12563 Dear Mr. McLoughlin: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 1 ROBERT MORRIS, PE Director of Environmental Health Re: Addition- A- 211 -06 No Increase in Number of Bedrooms McLoughin, 5 Yonkers Place (T) Patterson, TM # 25.47 -1 -47 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 July 18, 2006. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at two 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. This Department recommends you contact your local Building Department to ensure setbacks and other current codes can be met. 5. This 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 are the responsibility of the applicant and the jurisdiction of the Town of Patterson. If you have any questions, please contact me at (845) 278 -6130, ext. 2261. Sincerely, Gene D. Reed Senior Engineering Aide GDR:mcb cc: Building Inspector, (T) Patterson Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fax (845) 278 -6648 �sr ox �a��ez's�n ,N�• t�.sc�3 PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR-BEDROOM COUNT ONLY 2- BEDROOMS ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL 'SIGNATURE & TITLE qA uwamgA ._`f f. ,w PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCDOH FOR�APPROVAL OGNATURE . TITLE 4 DOE Bedroom 10' x 11' Bathroom 8' x 8' ri Bedroom 19' x 11' Hallway Area Computer room H LIVING AREA . MOW& . r UAI FlIV 16 H F-1 EX15TI047 -6A5i514t Aj-r -IV o 0AAxI%46S 5 yc;kp , ?\ae,2 Z-149 f26-,g7 -/-.1'7 PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL /S "SIGNATURE & TITLE (DATE/ i � . cL,, a nke r--N oftkoxa-'an ,V3 .1. k 2- 5-1 q* 7 - / - V7 LAMAF.fA UAI FlIV15 H F-'D -No owAAjc?j5:5