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DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 52. -2 -18 BOX 22 02577 : , , 1 ' , kNi On 02577 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA PAOLINARI, RN, MSN Associate Commissioner of Health DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 October 30, 2006 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Michael Mosny 243 Locust Ave. Corflandt Manor, NY 10567 Re: Addition -A- 300 -06 No Increases in Number of Bedrooms Mosny, 109 Oscawana Heights Rd. (T)Putnam Valley, TM83.57 -1 -74 Dear Mr. Mosny: 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 October -27, 2006.. The addition is approved with the following conditions: 1. The total number of bedrooms must remain at three without prior approval by this department. 2. 'Me aiea of 'the existing sewage disposal system, an d 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 Putnam Valley If you have any questions, please contact me at (845)278 -6130 ext. 2261. Very truly yours, Gene D. Reed GR: im Sr. Environmental Enginering Aide cc:BI (T)Putnam Valley Environmental Health (845) 278 -6130 Fax (845)'278 -7921 Water Supply Section (845) 225 -5186 Fax (845) 225 -5418 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention/Preschool (845) 278 -6014 Fait (845) 278 -6648 AVI SHERLITA AMLER, MD, MS, FAAP LORETTA MOLINARI, RN, MSN Associate Commissioner ofNealth DEPARTMENT 'OF HEALTH 1 Geneva Road, Brewster, New York 10509 ADDITION APPLICATION ROBERT J. BONDI County Executive ' LY -V' STREET TOWN f T AX MAP# 3S-/- - 7 lly q I X 9 L-j I & po,d � f/ NAME (G Sd� PHONE q1q "q0).PPCHD #�JQ 0--© MAILING ADDRESS DESCRIPTION OF ADDITION ad- -�OVlau�orut�l -7 / NUMBER OF EXISTING BEDROOMS 7 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 by a Professional Engineer or Registered Architect in accordance with applicable sections of.the Putnam County Sanitary Code. .- Please.subinit.this- form-and. the -following to•Putnam County Health Dept., 1 Geneva Rd,' ` ' Brewster, NY 10509, Phone: (845) 278 -6130. A Certified check or money order for $100.00. Sketches of existing floor plan (drawn to scale, all living area including basement) 3. Two sets of proposed floor plan (drawn to scale - with name, street and tax map #) / *Non- professional sketches are acceptable l4. Copy of survey showing well and septic locations 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. J5. Copy of Certificate of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE COMMENTS Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 WIC (845) 278 -6678 Fax (845) 278 -6085 � A.p . -_.. C�IERLI. TA:= rl =1l�,Ll✓It,.11Idk��lfiS;�FAAP; _ » � _ .. Commissioner of. LORETTA MOLINARI, RN, MSN Associate Commissioner ojHealth DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town Legal Bedroom Count .1OBERT J. BONDI County Executive Re: fh C kCk, l W05 k' V (Owner's Name) Tax Map #: Address: Town: Year Built: According to records maintained by the Town, the above noted dwelling, is— in compliance with Town Code. is not .4n compliance with Town Code. The Legal Bedroom Count is:�� This information has been obtained from: Certificate of Occupancy: Other: wilding Inspector Date Environmental Health (845) 278 -6130 Fax (845) 278 -7921 Nursing Services (845) 278 -6558 Fax (845) 278 -6026 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool (8451 M -Fnia 17— 1-4 —o e..0 .S rr A IO-Z 9AI ....... 63-N �m � .oar% \ 5 �iz % >< x`4 h 0c). 0 BaN... • nfPl • .... I ti� man s Gb Stone RU, 41 07 NN 0-70 99.99, r1 Y el - Af" of &-9-- —// —IV O 00) i T tol3kbl PUTNAM COUNTY DEPARTMENT OF HEAL. CV,,,` - � 0 $$ . DIVISION OF ENVIRONMENTAL HEALTH SERVICES . AP_PLICATJON.TO CONSTRUCT A .WATT i,,1L. ; _.._ _ please print or type PCHD Permit # Well Location: Street Address: Town/Villa e ��. Tax Grid # L��� / g /07 asca Wr� Vul << Map Bock Lot(s) Well Owner: ame M A ess L o D � IL tl ( e� IT Use of Well: Residential ublic Supply Air /Cond/Heat PurAp Irrigation 1- primary Business Farm Test/Monitoring Other (specify) 2- secondairy Industrial Institutional Standby Amount (of Use Yield Sought s gpm # People Served Est. of Daily Usage gal. Reason for Replace Existing Supply Test/Observation Additional Supply Drilling New Supply (new dwelling) eepen Existing Well Detailed Reason ` -k to e s 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 !✓ Name of subdivision Water Well Contractor: Lot No - isQ r'- C-✓ S �-: A, v M, el k ,^- o Address: Is Public Water Supply available to site? .................................. ............................... es No Name of Public Water Supply: Town/Village Distance tD property from nearest water main: Proposed well location & sources of contamination to be provided on separate sheet/plan. Dgte:..._(_ 40-1 ... ;_- Applicant Signature: Im.04,%- -. : _: 1 44 _ 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. &LJL APPROVED FOR CONSTRUCTION: This approval expires4we 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 well driller certified by Putnam County. Date of Issue 16 16 6 Permit Iss ' fficial Date of Eapirati n U 10 Title: Permit is Non- Transferr bl White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller Form WP -97 77 -- stone =U.fu 23*31'lo•6- 99.99, wo/ --I' 06pno" ct 63.41 0 Wx Lc cc s .1 l �ti i I � ' IN C\J- N I. J SSA "y4 I p t 1p C . try E .y . 47 s. 6� `,, ..5 7,5 A /Z o y V M. � ui 4)17-1 VE ly o� I. J