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631- 589 -8100
25.71-1-39
BOX 12
01294
F._ BRUCE' R...: FOLEY c ,.......- ..
Public Health Director
LORETTA MOLiMAM7R:N:; - M.S.N. "
Associate Public Health Director
Director of Patient Services
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 (845) 278 - 6014 Fax (845) 278 - 6648
Preschool (845) 228 - 5912 Fax (845) 228 - 6113
November 14, 2001
William Felica
80 Warren Dr.
Patterson, NY 12563
Re: Addition- Felica- Warren Dr.
No Increases in Number of Bedrooms
(T) Patterson Tax #,25.71-7,1-39
Dear Mr. Felica:
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 November ' 14.2001 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.
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,
Michael Luke
ML:kg" Public Health Technician
cc: BI(T)
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DEPARTNENT OF FMAI. TIT
Division of Environmental Health Services
4 Genave. Road
Brewster, New York 10509
Tel. (914) 278.6130 Fax (914) 378 - 7921
BRUCE R. FOLEY
.. _
Public Fealth• 'Jirectcr
STREET. /(�it/lG�//t/ �U/i _ . TOWN r1AP # CZ:!�!I.
NAa411L.l�_ FHO-."T /S&Y PCHD #
1 ZLAMNO ADDRESS
DESCR21 TiON OF ADDITION
\L�1BER OF E3aST?NG BE))ROO.NLSOL PROPOS D # CF BEnROMMS C
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM SULDNG ENSPECTOR)
Y
*.env addition which is considered a be&oom requires formal approval of plans (Construction
Permit) prepared by a Prof_ssional Engineer or Registered Architect in accordance with
aoplicabie sections of the Putzum Co-unty Sanitary Code.
Please submit this_fcrm z,:.d the fo'lowing to Putnam County Health Dept., 4 Geneva Rd.,
'Brewste *, NY 10509, Phone 278 -613o.
1. Certified check or money o.der for SI00.00
2. Sketches of existing floor plan (drawn to scale, all living area including basement)
" Non- professional skeicht.s are acceptable
3. Two .sets of proposed floor plan (drawn to scare, with name, street, and ter;: map T)
* Non- p.ofessionlai sk,eti. -he9 are acceptable
4. Copy of surycy shAawing well and septic location, to the best of your knowledge. Include date
of installation if isro. .Vn..Label all wets and septic systems within 200 feet of the p :operty.line.
Contact this office wish any questions.
5. Copy of Cent. of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
oFF�c.
C:ommen7s.
F:b 93
DEPARTMENT OF HEALTH
Division . Of Environmental Health ServIces
4 Geneva' Road, Brewster, New York 10509
(914) 278 -6130
BRUCE R..FOLVY. RS
Aeting Puhila .Neal[h .�r
Putnam. C ounty Dept, of Hvaiti
4 reneva Road
3:ew•strr, NY 105C9
Re:
csidenc�
Tax Map 0�•
Totivn
Centiemen:
A.ccoiding to record; maintained by the Tow-a, the above noted dwelling
iS
.S NpT
in complian:;e v,ith Totiti,. code and the total number dbedrooms on record
is
This information ;,as been obtai.11ed from:
CERTIFICATE Or OCCUPATvCY:
ASSESSORS RECORD:
01 HER f
B ink ins. ector
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iw..�.:., ._. '.�,,.::}m a+.: � -'•a:: Y <. - -4 -, :-� Y -�i :..f: ' ;.. ,,.,, .: ..� .. - �':..r .icK+;.•.r.� .- ;:.:iiti. _ .2'c ='e :� ,y �.�� _ — _ - __ _ _ c.;.:i
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
ONtmIS NAME
SITE IACATI01i
MAILING ADDRESS
X _ 4-*313 -Ve
-HONE OW —A-3,q
TM %/ 1 3 I fF
PERSON INTERVIEWED PCHD Ccmplaint #
Name & Relationship (i.e, owner, tenant, etc.)
DATE TYPE FACILITY 16S
PROPOSED INSTALLER /5c t .fcPZq1. PHONE -079-
REGISTRATION #_____
Pro (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.
....,ten �.,- -� ___� A— - - - -- ..� �:, � •.�,:�n --r� ;..,.
s.
Proposal approved - .Disapproved
Inspector's Signature & Title 000I Date
Proposal approved with the following 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 (e.g.,house corners).
d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diem. x 6' deep
drywells surrounded by one foot + gravel).
e. Installer's name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
_ -,I,.as.owner, or reported agent of owner agree to the above conditions._
SIGNATURE TITLE 4L DATE ,% -2R f _
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