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Home My WebLink About1068DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 25.49 -1 -17 BOX 11 oil . �. ON .I ON ON 11 r 1 il, i - L . ;r ` OWN IN m DEPARTMENT OF 'HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 2787-7921 BRUCE R. FOLEY Publi6' Heald 'Director PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY) STREET TOWN X MAP #(Zl NAME PHON0 o2 CHD # I4 33,?-9,P MAILING ADDRESS ' /y. lQZZ2P DESCRIPTION OF ADDITION NUMBER OF EXISTING BEDROOMS c PROPOSED # OF BEDROOMS" (FROM CERT. OF OCCUPANCY OR CtRTIFICATION 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 tlie followirig*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 living 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 MAIAAIMIRAtMinJpMtM7�. 1A1MYMIMIMIMIMIMt !U71.1n.M7MIMIMIMIMUAI ! AURA 9M 1eAMAIAlHM1l1A1AAIMI SAIMIIl111RA11. 1AfllilyI1Ai6AtMIH /911A1AA1MIQALIVS 1 �w J' s DEPARTMENT OF HEALTH Division i Of Environmental Health Services 4 Geneva* Road, Brewster, New York 10509 (914) 278 -6130 BRUCE R. FOLEY, R. S. Acting Public'.Health Director Putnam County Dept. of Health 4 Geneva Road Brewster, NY 10509 Re: A Residenc Tax Map Town Gentlemen: According to records maintained by the ToNNm, the above noted dwelling IS_.._. IS NOT in compliance with Town code and the total number of bedrooms on record is o` This information has been obtained from: CERTIFICATE OF OCCUPANCY: ASSESSORS RECORD: OTHER Building Inspector 4 �. DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509. Tel. (914) 278-6130 Fax (914) 278-7921 December 21, 1998 Ann and Donald Mill East Branch Road Patterson NY 12563 Re: Addition - Mi11, Camden Road Increase in Number of Bedrooms (T) Patterson, TM# 25.49 -1 -17 Dear Mr.. and Mrs. Mill: BRUCE R. FOLEY Public Health Director 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 latest revision date of December 17, 1998 and this Department's approval stamp. Based on the information submitted, the above mentioned 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. 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 yours William Hedges Sr. Public Health Sanitarian WH:tn cc: BI (T) PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL. INDIVUDAL ADDITION/REPAIR FORM SECTION A: GENERAL INFO R TION Name of Project 00 (T)m f �� TM# Year of Construction Size of Parcel SECTION B. TOPOGRAPHY (Please check all appropriate boxes) 1. ❑Hilly ❑Rolling ❑Steep Slope Chentle Slope ❑Flat 2. ❑Evidence of wetland ❑Low area subject to flooding DB--'odies of water J g t' ❑Drainage ditches Clock outcrop 3. Property lines evident? 4. Water courses exist on, or adjacent to parcel: S NO nY-E Lam" ❑ 5. Existing individual wells within 200ft of the existing SSTS? LJ ❑ SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS) 1. Physical character of existing SSTS area. A. ❑Level DGentle Slope ❑Steep slope B. ❑Well drained Moderately well drained OSomewhat poorly drained ❑Poorly drained C. Area available for SSTS. (Primary & Reserve) ❑Extremel limited LJSomewhat limited ❑Ade uate ft x ft Y q � — D. INSPECTION Date 1 Z- 1 -7 1 F Inspector ( o evidence of failure ®Evidence of failure OEvidence of seasonal failure -------------------- _---= - - - - -- -----=--- - - = - -- _ == - - - - -- ` - - -- r-- F HOUSE (1) Indicate location of SS A. Size and type of septic tank gallons Metal OConcrete OPlastic B. Type of absorption area 1. Fields ft. 2. Pits 3. Gallies ft. (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 rjPWS ❑Shared well 61�dividual well Mrilled ODug OCasing above ground COMMENTS : �U� (' h �'-� /� ek REPAIRS ONLY: Status: As Built Inspection Required: As Built Submitted: As Built Inspection Done: Inspector: �v A�Gif� %ov�J dAT a+J A) IL) r �o a d N+O�/ m l' )l c�e.0 LOA - ,--A MAP I Nt C-J2 0 11.1 t6 / ti D,o.) e- ck7ei 20 L----------- ENT OF -HEA P U T :A IM. HOUSE PLANS APMOVED FOR BEDROOM CO NIT 0;XV-, ate t o PQ te 0 13 .94 L,'„ " N'3 0 or,-" r 1 I i I iTNAiL1 . 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