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25.57 -1-4
BOX 11
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01154
LORETTA MOLINARI
Public Health Director
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/Preschool (845) 278 - 6014 Fax (845) 278 -6648
February 25, 2004
Nicholas Nelson, Jr.
Sarah E. Young
234 Lakeshore Drive
Brewster, NY 10509
ROBERT J. BONDI
County Executive
Re: Addition- Nelson/Young, 234 Lakeshore Dr.
No Increases in Number of Bedrooms
(T)Patterson, TM #25.57 -1 -4
Dear Mr. & Mrs. Nelson/Young:
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 February 25, 2004. The addition is approved with the following conditions:
:.
I_ _ .. - The total' number_ of bedroonis 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.
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.
Sincerely,
William Hedges
WH:Im Senior Public Health Sanitarian
cc:BI(T)Patterson
BRUCE R FOLEY
'ublie Health Director
DEPARTMENT • OF HEALTH
1 Geneva Road
Brewster, New York 10509
�d �
_ a►
LORETTA 'MOLINARI R.N., M.S.N.
Associate Public Health Director
Director of Patient Services
Environmental Health (845) 278 = 6130 Fax(845)278-7921
Nursing Services (845)278-6S58 WIC (845) 278 - 6678 Fax (845) 278.6085
Early Intervention (845) 278 - 6014' Preschool (845) 278.6082 Fax (845) 278 - 6648•'
ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET 23`1 Lo -lei
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NA11E PHONE(bN Z7a -1 c,ZZ PCM9 - d
MAELIN G. ADDRESS 23LI Lo -:ice Gso 4
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DESCRIPTION OF ADDITION
IN
rr%
NUMBER OF EXISTING BEDROOMS 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 b.y a- ?rofessiQnal.Engmeer or Registered Architect in accordance tivith applicable sections, of the
Putnam County Sanitary'Code.
Please submit this form and the following to_ Putnam County Health Dept:, 4 Geneva Road, 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 n)
*Non- professional sketches are acceptable.
C. 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 -
Continents /Jl
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02/10/04 14:39
Feb' 02 04 04:41F
GLEN GATE 4 845- 278 -7921
T0WM OF PATTERSO
845 -878 -2019
DSPARTNENZ• OF: HEALTH
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Tof. (974) 278 - bl39 Fax (9t 4) M8 - 7ftI
NO. 115 003
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KAZINQ ADDRESS
DISC T tON OF RDDMON
ANI,,NME.R OF EXSTJ,'qG BEDROO,-,fS v,?,- PBdPOSED # CF BZDR00. S /
(FROM CUT .O? OC'CJ!�ANCY OR
08RMCAMN. -PROM 9LIt.,C+►G IaiSpjECTOa,)
*Any addiUoA which is cor- dered s beditiom tegc!ires form=al appz'M1 ofplacs (Coasuuadoa
Pstntic? Psi e�-�d b }' a = r.l�ssioaPl En�Ceer px Reg:si»tzd .+�citect in accor�aez �r ;th
apiirable sections of the Pum= Cv =ty 946ta,*y Code.,
Plc.se submit this fcrm art to 1g1(rNing b'pvbU rrt CoLnty il.aith D,-pt, 4 tser.4va ?td.,
Hrsws;er, �'Y 1 OSC9, Prane 7'► 6.5' 3d. - - ...:. :.... _ ........._ . _.._.._.......� �. ,. _...__.
l- Cartified check or more} order for 5200,00
2. S' =hes of vdsting Uorplari (dma"wnto sceie,. AD living area includibg basemeat)
Nor: - professional sk%ca:s arc acc6ptble
3. Two nets of proposed tour plan (dawn to scare, with =no, stree', =d tw. trap
Nos -pra siorW sleet -tes are acccptabte
4. Copy of swvcy sBawiz- well and sepdc location, to the,best of your k +owledgr, Ia : :'lde date
of tnstall`ticn if known: Label all wells Lid smdc sysw= wit th 200 f.et of the p.-O be.
Contact this office wi$ any a uestons.
i.,Copy of Cerr, of Occupancy frm Tows or Certifitca60ri5!om Buildirg Dept,,xith regal
bedroom court of
0EM
Commew.s
�- - — �~ mom;:.* PI ITNAM rrn WTY DEPARTMENT OF P. 3
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02/10/04 14:39
--Feb 02 04 04:41pi
GLEN GATE 4 845- 278 -7921
TpWN OF PATTERSO
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DEPARTMENT Of HEALTH
DlvlA0n , Of Environments) Health Services
4 Ceneve Road, Brewster, New York 10509
(914) 278 -6130 ,
NO. 115 902
845 -878 -2019 p.2
Pty &r^ Couay Dept. of'iL°afth
4 GelievaRoad
Brewster, NY 105C9
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02/10/04 14:39 GLEN GATE 4 945 -278 -7921 NO.115 D01
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DATE: 9?!/f 0/ -
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* OF PAGES:
(Ind. this page)
-7ga1 NAME: PUTNAM COUNTY DEPARTMENT OF P. 1
f now or formerly XILLARD R., JR. & BARBARA G. DRAPER
t� ( Libor 1214, Pope X4
I LOT ?688
ran Pb h conrnrrs "Mr of hen ran pies n .a t, E.
Aamd as' s LOT 2712 hund�ar s, arc.
past ono nhr hoes RS' K, LO• E.
t r 0.B'µ of Irw 100.00'. fine.
a °�. hna•..... N 81.56'50" �' - -- -- vote as ,
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- - --- i LOT 2716 0
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SOU MERLY ON£- -HALF OF LOT 2684 10.00'
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LOT 2683 found as' s. a r' E. LOT 2717 rm ro° its m
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4REA- = 14,668 SO -FT..
( 0.3367 ACRE )
SURVEY OF PROPil