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62.13 -1 -7
BOX 24
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02859
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BRUCE R. FOLEY
` t`'ub'!ic Health ' Uirector �_ -• ° " " '` • • � • _ .._
.. . _ L•ORETTA IMIOLMART R. K M.S.N...
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster. New York 10509
Environmental Health (914)278-6130 Fax (914) 278-7921,
Nursing Services (914) 278 - 6558 WIC (914) 278 - 6678 Fax (914) 278 - 6085
Early Intervention (914) 278 - 6014 Preschool (914) 278 -6082 Fax (914) 278 - 6648
February 8, 2000
John & Nancy Rohrs
35 Hudson View Dr.
Putnam Valley, NY 10579
Re: Addition- Rohr.
No Increases in Number of Bedrooms
(T) Putnam Valley Tax # 62.13 -1 -7
Dear Mr. & Mrs. Rohrs:
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 Feb. 7, 2000 The addition is approved with the following
conditions:
1. The total number of bedrooms must remain at Four without prior approval
by this department.
7, -.. T iie ArPA of }}lo PY .�.•. iiTR Co'i�n RCS ��'1 �N C••n4._. «.1 .t --
. 1 "b " ' "b" �` Y� i systcmi, and its cxpdllsiVli area, nwA 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 your convenience.
ML:kg
Very truly yours,
Michael Luke
Public Health Technician
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY)
Public Health Director
STREET ��l/PWA,, lgV TOWN io, V, TX MAP # 7
NAME � PHO�y �" / HD
MAILING
DESCRIPTION OF ADDITION
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 by a Professional Engineer or Registered Architect in accordance with
applicable sections of the Putnam County Sanitary 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 (drawn to scale, all living area including basement)
* Non-.professional sketches are acceptable
I% 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
* Non.- professional sketches are acceptable
V4. 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.
V5. Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
OFFICE USE
Comments �
14 O X r
z• 3,''s —
Feb 98
a
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY)
Public Health Director
STREET ��l/PWA,, lgV TOWN io, V, TX MAP # 7
NAME � PHO�y �" / HD
MAILING
DESCRIPTION OF ADDITION
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 by a Professional Engineer or Registered Architect in accordance with
applicable sections of the Putnam County Sanitary 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 (drawn to scale, all living area including basement)
* Non-.professional sketches are acceptable
I% 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
* Non.- professional sketches are acceptable
V4. 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.
V5. Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
OFFICE USE
Comments �
14 O X r
z• 3,''s —
Feb 98
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 n
Re:
Gentlemen:
Residence
Tax Map t2_ 13 — 1-3
Town
BRUCE R. FOLEY, R.S.
Acting Public .Health Director
According to records maintained by the Tovim, the above noted dwelling
_ .... . __ IS
IS NOT
in compliance with Town code and the total number of bedrooms on record
is
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER
Q,j ��
Building Inspector
aid 10
PUTNAM OQUN T f DEPA�7MtPiT OF HEALTH
HOUSE PLANS APPP� )V' D FOR ? � ry
9
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SEDROMi-i COUNT 0"ILY; di
MY
2 7 a G. 0
'1 ; Date .
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DEPARTMENT OF HEALTH
Division of Environmental Health Services
TWO COUNTY CENTER - CARMEL, N.Y. 10512 (914.) 225 -3641
PCHD ..PERMIT. #�"'��g
WELL LOCATION
Street Address
Town /Village /City Tax
Grid Number
apsav yi�w �tiv�
Pveyv.-7 ✓i6ilEy �. �,!�-
/3 -
WELL OWNER
Name
Address
C3Private
/7P /�/ds,
sfdn F /9 s h7,-7vvc
O Public
USE OF WELL
O RESIDENTIAL O PUBLIC SUPPLY O AIR /COND /HEAT PUMP
O ABANDONED
(3)- primary
❑ BUSINESS O FARM O TEST /OBSERVATION
O OTHER (specify
2 - secondary
❑ INDUSTRIAL U INSTITUTIONAL O STAND -BY
AMOUNT OF USE
YIELD SOUGHT
gpm /# PEOPLE SERVED S /EST. OF DAILY USAGE gal
REASON FOR
ONEW SUPPLY
OPROVIDE ADDITIONAL SUPPLY
OTEST /OBSERVATION
DRILLING
OREPLACE EXISTING
SUPPLY eDEEPEN EXISTING WELL
DETAILED
REASON FORs�
DRILLING
WELL TYPE
LffDRILLED
®DRIVEN ®DUG
[D GRAVEL
® OTHER
IS WELL SITE SUBJECT TO FLOODING? YES -A- NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No.
WATER WELL CONTRACTOR: Name Address: p°.�i�n C'o.
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE:
YES X NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
P1.S 0 -PROPE-TsT::.,FROTM 11(
LOCATION SKETCH & SOURCES OF CONTAMINATION
rTON REAR OF THIS APPLICATION
2 -2.-k7
(date)
PROVIDED
®ON SEPARATE SME j
(signature)
PERMIT
TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the
provisions of 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 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 attached to this permit.
3. Submit a We ll Completion Report on a form
Health De art lent. 5� n
Date of Issue: 19
Date of Expiration: 19
Permit is Non - Transferrable
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SURVEYED 17 945
JOHN SALVATORE. ROMEO
1.11ij: 1.1,
I'Coniulting Engtne#r & Land SAirveyor TOW-A
lylw-,64�4 N'O'RTHfUDGE ROAD
: RECEIVED
N.Y.
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OACH"kiNTS BELOW GRADE IF ANY NOT SHOWN %waulat AT LAW sbkVi
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