The URL can be used to link to this page

Home My WebLink About2075DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 36.49 -1 -1 BOX 18 02075 ID'1710 IN DID -cm oi him i is . -r r . 6 T., I , �. ,I r � f +. r r 16 DID.. 6y ., DID . w'. I ms I 1 1' ,, ` ED 02075 T SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Charles Shroba 10 Ulster Rd. Brewster, NY 10509 Dear Mr. Shroba: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive April 25, 2005 Re: Addition — Shroba, 10 Ulster Rd. (T)Southeast, TM #36.49 -1 -1 I have received and reviewed the plans for the proposed addition at the above mentioned residence. Based on the information submitted, the above mentioned addition cannot be approved for the following reasons: 1. A finished room over the garage is considered a potential bedroom. 2. The legal bedroom count for the dwelling is two. The potential bedroom count of your proposed addition is three. 3. The addition of a potential bedroom requires this Department's approval of a revised septic system plan from a professional engineer. Please revise the proposed floor plan to reflect no more than two potential bedrooms, or have. a professional engineer or registered architect design a sub - surface sewage treatment system meeting present code requirements. If you have any questions, please contact me at your convenience. RM: hn V ly yo obert _Morris Senior Public Health Engineer Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 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 03/31/2005 09:55 FAX 914 241 382 ENT 74 wd MAR-31-2005 THU 10:49 TEL:845-278-7921 fAAME:PUTNAM COUNTY DEPARTMENT OF P. 2 lv. IN ENT 74 wd MAR-31-2005 THU 10:49 TEL:845-278-7921 fAAME:PUTNAM COUNTY DEPARTMENT OF P. 2 03/11/2005 09:54 FAX 914 241 3827 PATIENT ACCOUNTS • NWHNORiH cMI HOSPITAL R 400 SW- ztisati St MC Kbco, NY 10549 9j.4 -666 -1701 DATE: L j ^ �`oo: q 5- TOTAL OF PAC- INCLUDi�G COV1R ,SEE-T: �J SF,NT TO: t- j r) Gf G- FAX r�r:! F.ErftX FAX r-: fa"i 94i -0827 COMMENTS:! CONX-3D ,. TL PIFORTI�P_?3ON ENCLOSED [a 001 /003 THIS TRgNSMISSION IS INTENDED ONLY FOR THE INDIVIDUAL OR ENTITY TO WHICH IT IS .ADDRESSED AND CONTAINS INFORMATION THAT IS CONF]DENTIAL. IF YOU HAVE RECEIVED THIS'COIYlMM'ICATION IN ERROR, FLEASE DESTROY THE FAXED MATERIALS AND:.CONTACT THE SEA-DER IMMEDIATELY- THIS INFORIVLALTION HAS BEEN DISCLOSED TO YOU FROM CONFIDENTIAL RECORDS AND IS PROTECTED BY FEDERAL AND STATE LAW. THIS INFORMATION MAY INCLUDE CONFIDENTIAL MENTAL HEALTH, SUBSTANCE ABUSE, ALCOHOL ABUSE AND /OR HIV - RELATED INFORMATION. FEDERAL AND STATE LAW PROHIBITS YOU FROM MATING ANY FURTHER DISCLOSURE OF TIES MORMATION VMHOUT THE SPECIFIC WRITTEN CONSENT OF THE PERSON TO WHOM IT PERTAINS, OR AS OTHERWISE PERMITTED °BYW NY UAUICP=D UTR DISL-GSUE VOAI03`OFT I _ L FINE QR JAIL SENTENCE OR BOTH. A GENERAL AUTHORIZAnl JW THIS INFORMATION MAY NOT BE SUFFIC8NT AUTHORIZATION FOR FURTHER DISCLOSURE. I MAR- 31- 2005. THU 10:48 TEL:845- 278 -7921 NAME:PUTNAM COUNTY DEPARTMENT OF P. 1 03/31/2005 09:55 FAX 914 241 3827 PATIENT ACCOUNTS 777' W_ JP003/00 3 • vlay-.'-'_ Aq YZ t L. - Iv k' x A -4�71 -6 O-Q 1 W 1 .77 v WIN ; I �21' Mp fp. .4 , A Lt.n-, b L Aj& iy t =it -t.'4 F, so. ompust&AW, 4 g Z Q P!�� YM40 Emu R_.Lf4_. __p 2plwiwlw- vow wl wov .5 V*M. -low . M :0720A MU - .9 MIR., Im. %*4,rA *00, P5 � lil ". , ,,, , 's �. .. . I M V; z, a n "I IP ;�kq(XZ V vl*l jw* f is COUNTY DEPARTMENT OF P. 3 ii-01 co BRUCE K FOUY HeCIIA Dir_vr -- D$PARTNSEIN i OF IMALTH Division of En it ?1=nftd Health Services 6 Genava Road Brewster, New York, 10509 Tel. -(914) 278.6130 Fax (914) 278 - 1921 22,,)pOc .DADD- MQN 6BpUCAT STREET /o liLS r��'z 1tA TOWIN ;�' TxmA? # 3�" y� NA�v'IE OLtAAtN AP06.4- PHOti'E &9 -o(o4Z PCHDr A - MAll DID ADDRESS /o IA f g re rz ILA A)Y 10-S-O? IDES C'.RRPTi ON? OF ADDITION r �y, j h sP�tk y� r ,4 r r RC iti!A S �z NL IBER GF E3aSTINL G BEI)R00N3 Z— 'PROPOSED d# OF BEDROOti1.S Z-- (FROM CERT. OF OC:CiP. ANCIt OR -- _ 'At1v addition -,Nriiclz is cons:derod s bedioom iequires fo rmal approval of plans (Coastruction Permit) prepzPd by a Pref_ssional Eagineer. or Registered Arc'l tect in accordance with aoplicab:e sections cf the Pumzn, Cou-1ty Sanitazy Code, Please submit this form w,.d the fo2oNing to Putnam Co=r.v Health Dept., 4 Geneva Rd., Brw-s=..*., NY 1'0509, Pbcue 279- �: :30. 1. Certified,check or mor�ey- order for 5100.00 Rztches of exizting floor plan (drawn to scale,. all living area IDcluding basement) Non - professional sketches are acceptable 3. Two .sets o: proposed Lour plan (dawn to scare, with name, street, and tw. map 4) *No n--pm --ssionai sketches are acceptable : 4. Copy of sarsrry s ;owing well and septic location, to the best of your Lra ledge. Include date of installation if kno.-wn: Label all Sells aid septic systems within 200 feet of the p:operty lane. Contact this office wi any questions. 5. Copy of Cent. of Occupancy from Town or Certification ]a-a=. Building Dept. �Mth legal. bedroom court of dw :Icing. OFFICE US C; o mrnew.s F* 93 DEPARTMENT OF HEALTH Division . Of Environmental Health Services Geneva' Road,-Brewster, New York 10509 (914) 278 -6130 Putrm County Dept. of Health 4 Oenn:a Road 3:ewste -, NY 105C9 BRUCE R._FOLE'�, A c Aetlnp PUM0 Health Re: !�rh e c, Residence Tax Maps Town ��7 T�- •�s'.�" _ . According t.o records maintained by the To%�—,y the above noted dti--.elling in com- pliance v,;th Tom T. code and the total number of'aedroorn: on record IS This infoimation'aas been obtained from: CERTIFICATE OF OCCUPAINCY: Aj SESSORS PECORD: O': HER Building ins; ector , i i I i , PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES APPLICATION TO CONSTRUCT A WATER WELL please print or type PCHD Permit # I r A Well Location: Street Address: Town/Village Tax Grid # 3&. q q — / y-• / 10 Lk 1AW 5 6—Y- Map Block Lot(s) Well Owner: Name: Address: IV&Yfh Qdw PcvttL46 1-5 Pr ress St s N y /vsz�9. Use of Well:_ Resid tial Public Supply Air /Cond/Heat Pump Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondary Industrial Institutional Standby _,g Ppwz I i -t-- Amount of Use Yield Sought _� gpm # People Served Est. of Daily Usage Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) Deepen Existing Well Detailed Reason - — ] OW for Drilling Well Type Drilled Driven Gravel Other Is well site subject to flooding? . ............................... Yes No Is well located in a realty subdivision?. ...................................... ............................... Yes No X Name of subdivision - Lot No. Water Well Contractor: pyWd 1 ( +&fk,,n LJM CO in Address: 165q fZ S Z Ca ,,met N y i os-12 Is Public Water Supply available to site? .................................. ............................... Yes No Y— Name of Public Water Supply: Town/Village Distance to property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Date: Applicant Signature: A2 is t PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED FOR CONSTRUCTION: This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be `- amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water a driller ertified by Putnam County. Date of Issue l P�r d Permit Issuing Official Date of Expiration . e• ''Permit is Non- Transf rra le White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 KITCHEN AND BATH LAYOUT Store # Q 1n 11 19 13 14 15 16 17 18 19 20 21 22 23 24 J�