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631- 589 -8100
36.25 -1 -27 & 36.25 -1 -28
BOX 18
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01944
_a......:.b , u....- �. BRUCE K- FOLEY
Public Health Director
DEPARTMENT OF HEALTH \`Q
Division of Environmental Health Services,
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278 - 6130 F=(914)278-7921
PROPOSED ADDITIO \T APPLICATIO \T (RESIDENTIAL OVI,I� �U(I
STREET -it TX
ii
NAME�6fl , rn o n $HO PCHD rL
MIAILLNIG ADDRESS In :I-- L %aa
DESCRIPTION OF ADDITION-19a, i 5- a a AP _ 4 E.
NUMBER OF EXISTING BEDROOMS PROPOSED. OF BEDR_ OO-NiS
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM,BUILWNG L•-SPECTOR) .
*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-Sane Code_
Please submit this form and the following 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 (d -yawn to scale, al! Lining area including basement)
* Non - professional sketches are acceptable
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map iD
* 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 93
DEPARTMENT OF HEALTH
Division, Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
BRUCE R. FOLEY. R.S.
Acting Public .Health Director
R,
Residence
Tax Map
Tovm
Gentlemen:
According to records maintained by the Town, the above noted dwelling
JS :... _ ._....._:._
IS NOT
in compliance %with Town code and the total number of bedrooms on record
is
v'
This information has been,obtained from: -:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER _
0
R»ilrlir►a �nenPr•tnr
(31,
BRUCE R. FOLEY
Public Health Director
DEPARTMENT OF
1 Geneva Road
Brewster, New York
HEALTH
10509
LORETTA MOLINARI RN., M.S.N.
Associate Public Health Director
Director of -•Patient • Services'• =
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 Preschool (845) 278 -6082 Fax (845) 278 - 6648
Susan & Richard Salamone
6 Ilion Rd
Brewster NY
Dear Mr. & Mrs. Salamone:
July 20, 2000
Re: Addition- Salomon - Ilion Rd
No Increases in Number of Bedrooms
(T) Southeast Tax # 36.25 -1 -21
I have received and reviewed the plans for the proposed addition of the above - mentioned
residence. The proposal for the addition has been approved as per plans bearing the approval
stamp form this Department dated July 20, 2000 .The addition is approved with the following
conditions:
1
2
...._. _ ... _?:._. ,,
The total number of bedrooms must remain at ee without prior approval by
this department.
The area of the existing sewage disposal system, and its expansion area, must be
maintained.
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 Southeast.
If you have any questions, please contact me at your convenience.
Very truly yours,
William Hedges
WH:kg Senior Public Health Sanitarian
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