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631- 589 -8100
62.26 -1-45
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03072
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P AM CQ DEPARTMENT OF HEALTH `.
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bot Address
Pirate 7FOrage System
7711
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Silo V; _;;.LPubffC , !Ipl, , JY'Fr6161 Ad&m
private. So
Control Bees a
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-7= '3 Has Garbage Grin ja�: ledY
Miiiber of Be&66
to a.
serving y .0
certify that the syst i� lisi�d,sery the above :Premise#:.�!�rs construct .�q": on the r plans of the completed,work
with the ac
rd a filed plan, lards; and r Abe P a and the permit issu the
ssu�
of-w4Wi.ari attached) and in accordance I I ,
"Cd6n Health
C
q&F -R.A
A . ddress /\% 'License 149.
V
parson PccUpylr served 6� ths'�bdve i�s6W(Q �shijI:.�ror6`ptIy',;a.kq,wch Action as maybe n"Siry 9 0 1
t secure the co�rectlon. of y.un�anitary
Py'
yrern so$ so unitaij ewer, beconm
;Approval ��of; stern. shill e null.and.461d'as on'ii
rt Iic WPOIj ifi6rrkei -.:�:Utii iii6rovals are
&I of 0", ul F
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"* ava11ab1e.anC a APPT �00,�AUPPIIY �! -1
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6 or.,c A'Age,When in - Ine'l udgrnen 0 o6j" modification nan
7It la
YML ENVIRONMENTAL SERVICES
321 Kear Street
Yorktown Heights, N.Y. 10598
(914) 245-2800
Albert H. Padovani, Director
LAB #.' 32.406568 CLIENT #3 4893 NON STAT PROC PAGE I
---------- 11 -1--- --NIL I ------- I-- -------- -------------------------I4.----NN-------
HONORS, TIM DATE/TIME TAKENS 04/20/95 07030
1180 MIDLAND AVE APT 2A DATE/TIME REC'Ds 04/20/95 15 45
SRONXVILLE, NY 10708 REPORT DATE: 04/25/95
PHONE: (914)-779-6837
SAMPI-ING, SITEIR 47 WENOAH RD OUTSIDE SPIGOT SAMPLE TYPE...s POTABLE
PUTNAM VALLEY, NY PRESERYATIVESS NONE
COLD BY9 TIM HONORS -TEMPERATURE ..s < 4C
NOTES...9 COLIFORM METHS. MF
--------------------------------------- ---------------------------------------
DATE FLAG PROCEDURE RESULT NORMAL – RANGE
04/21/95 MFT. COLIFORM ABSENT /1,00 ML ABSENT
COMMENTS00
RACT THESE RESULTS INDICATE THAT-THE WAT WAS ,(WAS NOT) OF A
SATISFACTORY SANITARY DUAL ITY ACCOR'rTN!!3 O)THE NEW YORK STATE
AND EPA FEDERAL. DRINKING WATER STANDARDS, FOR THE PARAMETERS
TESTED, AT THE TIME 00 COLLECTION.
SUBMITTED
–w – -------------- —
Albert H. Padovani7 M.T.(ASCP)
Director ELAP# 10323
PRII'NAM COWN DEPAI -,`f FNT OF f11 ?J1I,N-1
DMSION OF ENVIRONMaTAL HEALTH SERVICES _
i x �.`o'nv.:.. a -:gym; - .�o.'a:p�- :k,:- °. � .:•:��-r: - =.. -. - ...co,a. _, - _ _�_a� .....:; -�: �:�:;::r�:.�.- -.r:s;o ..•+�..:;::a+� ...y:; 5.;.::::s� •... - ='- w�.ee:c..::.��.�..'.:d.: +..
Owner or Purchaser of.Building Section Block Lot
Building Constructed by
E�00 OA H �D
Location - Street. J Sut�iivision Name
Municipality Subdivision Lot #
Building Type
GUARANrEC OF SUBSURFACE: SO AGE DISPOSAL SYSTEM
I represent that I am wholly and completely responsible for the location,
workmanship, material, construction and drainage of the sewage disposal system
serving the above described property, and that it has been constructed as shown on
the approved plan or approved amendment thereto, and in accordance with the
standards, rules and regulations of the Putnam County Department of Health, and
hereby guarantee to the owner, his successors, heirs or assigns, to place in good
operating condition any part of said system constructed by me which fails to
operate for a period of two y ars inniediately following the date of approval of the
" Certificate .o. - ,Construction. Compliance" .for the savage d.i51?osal system, or any
.__..__.o.Ye� all "5 "u 'eVLy'Ii� CU Silt.'ii �y5f tiiij- except wile:te "t;" i fciii ie ""IE0
caused by the willful or negligent act of the occupant of the building utilizing
the system.
The undersigned further agrees to accept as conclusive
the Director of the Division of E:nvironinental Health Services
Department of 11calth as to whether or not the failure of the
caused by the
the sysLau.
willful or negligent act of the occupant of th
e
Dated this day of S— 191 Signature
Title
General Contractor (Owner) - Signature
Corporation Name (if Corp.) '1
?ce, v.y ;1 \Y N
UN,
rev. 9/85
mk
the determination of
of the Putnam County
system to operate was
building utilizing
Corporation Name (if Corp.)
Address
j
@►0Tl.
WGLL UVrlrLGiiV" Az-rvaL
DEPARTMENT. OF HEALTH
�_.ce: � •[u,�'y�.. ..s� .�...:.. e..r.. -: •.. ,t r L a �,y'� -.- ..... �!Y3:. w_1:.` >S Mme... .6 :v, -a.,. _. va. Cw.- ..v ias:._•
PUTNAM 'COUNTY DEPARTMENT OF HEALTH
Office Use Only
c.:: �• a.: �.. y�:. :aa��ii.w+a- .•n.k..c.- ...-.. r.. -. _..._....
WELL LOCATION
STREET AOURESS: '11WNIVILUIC17CRY TAX GRID NUMBER:
I f 416
WELL OWNER
NAME: ADD S: ' /
7; i» 4- c k 47 /6zd
Q- PtIVATE
❑ PUBLIC
USE OF WELL
1- primary
2 - secondary
8�ESIDENTIAL U P BLIC SUPPLY ❑ AIR /COND. /HEAT PUMP ❑ ABANDONED
SINESS ❑ FARM ❑ TEST /OBSERVATION ❑ OTHER (specify)
❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑
MOUNT OF USE
YIELD SOUGHT S� gpm. /N0. PEOPLE SERVED / EST. OF DAILY USAGE .gal.
REASON FOR
DRILLING
❑ PLACE EXISTING SUPPLY ❑ []ADDITIONAL ADDITIONAL SUPPLY
(EW SUPPLY (NEW DWELLING) . []DEEPEN EXISTING WELL
DEPTH DATA
WELL DEPTH 3 Lfy ft
STATIC WATER LEVEL 30 ft.
DATE MEASURED a
DRILLING
EQUIPMENT
OTARY ❑ COMPRESSED AIR. PERCUSSION ❑ DUG
❑ WELL POINT. ❑ CABLE PERCUSSION ❑ OTHER (specify):
WELL TYPE
❑ SCREENED U- PEN END CASING ❑ OPEN HOLE IN BEDROCK ❑ OTHER
CASI NG
DETAILS
TOTAL LENGTH _ a! ft-
MATERIALS: ta-STEEL ❑ PLASTIC ❑ OTHER
LENGTH BELOW GRADE ,5 ft.
-
JOINTS: ❑ WELDED THREADED ❑ OTHER
DIAMETER in.
SEAL: QICEMENT GROUT ❑BENTONITE ❑OTHER
WEIGHT
PER FOOT Ib. /ft.
DRIVE SHOE: ❑ YES
LINER: 0 YES �Ne
SCREEN
DETAILS
I
DIAMETER (in)
7SLOT SIZE
LENGTH (ft)
DEPTH TO SCREEN (ft)
DEVELOPED?
FIRST
0 YES ONO
SECOND
GRAVEL PACK
O YES
0 NO
GRAVEL
SIZE
DIAMETER
OF PACK In.
TOP
DEPTH -ft.
BOTTOM
DEPTH ft.
WELL YIELD TEST It detailed pumping
METHOD: O PUMPED tests were done is in-
QOMPRESSED AIR , formation attached?
O. BAILED O OTHER ; ❑ YES 0 NO
WELL LOG it more detailed formation descriptions or sieve analyses
are available, please attach.
DEPTH FROM
SURFACE
Water
Bear-
ing
Well
Dia-
mete
FORMATION OESCRIPnON
COE
ft.
WELL DEPTH
ft.
DURATION
hr. min.
DRAWDOWN
It.
YIELD
gpm.
Surface
WATER O CLEAR TEMP.
QUALITY 0 CLOUDY HARDNESS
0 COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? OYES ONO
STORAGE TANK: TYPE
CAPACITY GAT..
WELL DRILLER NAME DATE
ADORES i" o Y� 6t ,r t& i1��S lIG" �l
+� C) �� ��A
(A MiI !V�
PUMP INFORMATION
TYPE - n�� : �tiQ �'' - CAPACITY
MAKER - r i t ,1 t 41 s DEPTH 3 v 6
MODEL VOLTAGES , HP
NOV
,:"00,e,M
C�.
WbLL UUr1rLL11VD4 Mr?"Al
DEPARTMENT OF HEALTH
PUTNAM COUNTY DEPARTMENT OF HEALTH
'Office Use Only
WELL L,0CATIQN
V.
STREET ADDRESS: TDWN/ ILLAQ1 lCIIy TAX GRID NU&ISER:
�q 16 n10 6/1" A, XlZI /oS-
/4
p
WELL.OWNER.
NAME: AOOR S:
7i Ph et� 4- kn"l L L k q17 L,2�, ;1 O'k
JJ[��-PBIVATE
0 P 8 LIC
U
USE OF WELI
'
;secondary;
RfESIDENTIAL ❑ SUPPLY 0 AIR/CONO./HEAT PUMP 0 ABANDONED
BUSINESS USINESS 0 FARM ❑ TEST /OBSERVATION 0 OTHER (specify)
0 INDUSTRIAL 0 INSTITUTIONAL ❑ STAND BY 0
MOUNT WUSIE
YIELD SOUGHT gpm./NO. PEOPLE SERVED EST. OF DAILY USAGE gal.
REASON FOR
DRILLING: !
CIR/EPLACE EXISTING SUPPLY ❑TEST/OBSERVIATION ❑ADDITIONAL SUPPLY
EW SUPPLY (NEW JY,4ELLING) ❑DEEPEN EXISTING WELL
DEPTH DATA .
3 �v
WELL DEPTH ft. [STATIC
WATER LEVEL. ��ft.
DATE MEASURED
,,kQQIPMENT!..
040TARY 0 COMPRESSED AIR PERCUSSION ❑ DUG
❑ WELL POINT ❑ CABLE PERCUSSION 0 OTHER (specify):
E.
PEo
❑ SCREENED U16PEN END CASING ❑ OPEN HOLE IN BEDROCK 0 OTHER
i ;CASING
PET. ILS
TOTAL L� NGTH ft-
MATERIALS: Q-STEEL 0 PLASTIC 0 OTHER
LENGTH BELOW GRADE ` ,5 ft.
JorffS: ❑ WELDED E),THREADED 0 OTHER
in.
DIAMETER
SEAL: RfEMENT GROUT ❑ BENTONITE 0 OTHER
WEIGHT PER FOOT Ib./ft.
I DR!VE SHOE. 0 YES CLW"j'
LI ER: 0 YES NO
SCREEN
DETAILS
DIAMETER (in)
'SLOT SIZE
LENGTH (11)
DEPTH TO SCREEN (it)
DEVELOPED?
FIRST
0 YES ONO
SECOND
G AVEL PACK
0 YES
0 NO
GRAVEL
SIZE.
DIAMETER
OF PACK —in.
TOP
DEPTH ft.
BOTTOM
Dm — ft.
WELL YIELD TEST .1 It detailed pumping
(k�l
METHO PUMPED 1 tests were done is in-
0, 60MP AiSSED AIR 1 formation attached?
0:'EIAILEO'� 0 OTHER IOYES ONO
.11 more de-,ailed formation descriptions or sieve analyses
WELL LOG if availj fe, please attach.
DEPTH FROM
SURFACE
water
ing
We "
Dia
M.
in
FbAMA'nON DESCRIPTION
CODE
it.
WELL OEM , ,
DURATION
hr. min.
DRAWDOWN
It.
YIELD
Land
surlace
J, .5
3 C)
WATER CLEAR TEMP.
W I
QA
UA
QUALITY 0 CLOUDY HARDNESS
0 COLORED ANALYZED? OYES ONO
ANALYSIS ATTACHED? 0 YES 0 No
STORAGE TANK: TYPE
CAPACITY GAS..
WELL DRILLER NAME A
ADORES i Vor
C) b's
(41
PUMP INFORMATION
I
TYPE . �."Vloz CAPACITY
MAKER r_uA POS DEPTH 3 o 5
Moo
MODEL VOLTAGE2,-h— HP _�zz
s' (FM. N71040'W) BO. N"W $ g 7 .
,.
It
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Po—
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0
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This is to certify that the sewage disposal system we
o constructed as indicated on this plan and . that tt
system was inspected by me before it was cove
ed over. The system was constructed in accordanc
with all the rules and regulations of the Putnam Cou
ty Department of Health.
m.
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FREDERICK A. ZENZ i \
292 MAIN ST.
NELSONVILLE, N.Y. 1051 �2s
s No
,e. O
SEPARATION DISTANCES /IV FEET
I 1813 • a 61710*1*11djaltalal 14 113 it Iff In to ao y
• so 24 s6 g1h'K ;Q5 63 68 13 S9 4 "r 53• S1 63 t, 72 o ., - . ..�...
' 45' 3 3b 6i ; i2 77 81~ 28 96 4t 46 53 59 6s 71 li t1
AS BUILT SURVEY BY BADEY 8 WATSON. L.S.
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Putnam County Department of Realth
Division of Environmental !Rea lth Services
Approved as noted for conformance with
8pp1, •e Rules and Regulations of the
Coun jeaa�l�thh Department. _
Signature k Title Da o
AS —BUILT SEPTIC PLAN
prepared for
HONORS RESIDENCE
WENONAH ROAD SCALE: 1".30'
TOWN OF PUTNAM VALLEY 5/10/95
PUTNAM COUNTY, N.Y. M • 62.26 B 1 L 45
C�
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25.7
M
O n
m'
This is to certify that the sewage disposal system we
o constructed as indicated on this plan and . that tt
system was inspected by me before it was cove
ed over. The system was constructed in accordanc
with all the rules and regulations of the Putnam Cou
ty Department of Health.
m.
1
<1<0"F
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� O�RII
4Q� @i
FREDERICK A. ZENZ i \
292 MAIN ST.
NELSONVILLE, N.Y. 1051 �2s
s No
,e. O
SEPARATION DISTANCES /IV FEET
I 1813 • a 61710*1*11djaltalal 14 113 it Iff In to ao y
• so 24 s6 g1h'K ;Q5 63 68 13 S9 4 "r 53• S1 63 t, 72 o ., - . ..�...
' 45' 3 3b 6i ; i2 77 81~ 28 96 4t 46 53 59 6s 71 li t1
AS BUILT SURVEY BY BADEY 8 WATSON. L.S.
u e.
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I' e
f I W me
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Putnam County Department of Realth
Division of Environmental !Rea lth Services
Approved as noted for conformance with
8pp1, •e Rules and Regulations of the
Coun jeaa�l�thh Department. _
Signature k Title Da o
AS —BUILT SEPTIC PLAN
prepared for
HONORS RESIDENCE
WENONAH ROAD SCALE: 1".30'
TOWN OF PUTNAM VALLEY 5/10/95
PUTNAM COUNTY, N.Y. M • 62.26 B 1 L 45
W1
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New. York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
BRUCE R. FOLEY +�
iehlk !Yeakh •Dircc nr
PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY)
STREET \4,1 e,n0 A(A SO— TOWN 4A, MAP
NAME , \44 i A 1. PHON � IPCHD #
MAILING ADDRESS
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.
lease 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
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
'Y * 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
- . if ..r _ - s... .. . .. .. . �.� w � .�......p •Y . • N.. i -. v...n --.. .
Meryl Kubrick
49 Wenonah Road
Putnam Valley NY
Dear Mr. Kubrick:
DEPAR.TNMNT OF BEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 278-7921
November 19, 1998
10579
Re: Addition - Kubrick, Wenonah Road
Increase in Number of Bedrooms
(T) Putnam Valley, TM# 62.26 -1 -45
BRUCE R. FOLEY
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 latest revision date of
November 19, 1998 and this Department's approval stamp.
Based on the information submitted, the above mentioned addition is approved with the following
conditions:
1. The total number of bedrooms must remain at three without prior approval by this
Department. _..:... _ _.._ ....:...:. .. .
The afea -u 't ie existing sewage ` dispo -sai 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 Putnam Valley.
If you have any questions, please contact me at your convenience.
Very truly yours,
William Hedges
Sr. Public Health Sanitarian
WH:tn
cc: BI (T)
0
;�. � +.a •s�.,.v .`.ter .o- ..+.r =� ,.,am.'n . . �. ..n•Lr. - � ._. _
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
INITIAL INDIVUDAL ADDITION/REPAIR FORM
SECTION A: GENERAL INFORMATION
Name of Project �/ 7 m, v ,,&4 d (T)(V) e. V ' TM#
Year of Construction Size of ParcelTC(
SECTION B. TOPOGRAPHY (Please check all appropriate boxes)
1. Milly ORolling ❑Steep Slope ❑Gentle Slope DFlat
2. ❑Evidence of wetland Clow area subject to flooding ❑Bodies of water
ODrainage ditches ORock outcrop
XES. �
3. Property lines evident?
4-. Water-couises exist'bn, or adjacent*to parcel
5. Existing individual wells within 200ft of the existing SSTS?
�'. ❑
SECTION C. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM(SSTS)
1. Physical character of existing SSTS area.
A. ULevel ❑Gentle Sloe ❑P Stec slope
'
P P e
B. ❑Well drained Moderately well drained
❑Somewhat poorly drained OPoorly drained
C. Area available for SSTS. (Primary & Reserve)
®Extremely limited 01slomewhat limited ❑Adequate ft x ft
N
Z7D, ,e-. .. .e• .c+.: r r. . r L .a �.! a --e'a^: Y' 3 . i K .a W.e.c.v.rt i �— . .-
..e..- ..e A• v ..• • - .�_f.p s. +a�:rC^•.. .'C sC.r �.0
D. INSPECTION Date Y . Inspector
3No evidence of failure ®Evidence of failure ®Evidence of seasonal failure.
N
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--------------------=---------------------=-------- - - - - -- ; -------------------------:-----
(Indicate North)
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------------=----------------------------------------------------------------------------- - - - - --
(1) Indicate location of SSTS .
A. Size and type of septic tank gallons
Metal OConcrete ®Plastic
B. Type of absorption area
1. Fields ft. 2. Pits 3. Gallies ft.
— ictdivate setbadks,- frbnt'stieef "ff( ar-d -and side and dimensions
(3) Show location of well
(4) Show location of driveway
(5) Note physical features (steep slopes, rock outcrops, streams/wetlands)
SEC'T'ION E. EXISTING NVATER SUPPLY
[jPWS []Shared well Mdividual well
[)Drilled 171Dug [lasing abo-ve ground
COMMENTS e-, vG
REPAIRS ONLY: Status:
As Built Inspection Required: As Built Submitted:
As Built Inspection Done: Inspector:
(nrldrPn)
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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
Gentlemen:
BRUCE R. FOLEY, R.S.
Acting Public Health Director
Re:. I 1 16
Residence A V -
Tax Map
Town
Ir
According to records maintained by the Town, the above noted dwelling
0
IS NOT
in compliance-with o,"m code and the total number of bedrooms on record
is
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD:
OTHER '�YcJS
Building Inspector
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SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health .
v � r .a •.:.d.4L. T .r. c.O+t v.J "hpca w_.yye�_.+se[. rc�..r -._ - lY
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
ROBERT J. BONDI
County Executive
`-+r_ �. .0 V.T.•. T..a:fT+ � .ni Ya ... _. T .. •vwa..wa 1 . .. � • � ..r . .. .r ...r tti
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
ADDITION APPLICATION RESIDENTIAL ONLY
STREET 41'? Wen.On-A U 2O TOWN wft , Va-h TAX MAP# O 44
NAME ,`m I&ot;5 PHONEVr,�Q& 3S�a PCHD #_
MAILING
ADDRESS
DESCRIPTION OF m
ADDITION ADt) S"C fey n : Wig�4WS
NUMBER OF EXISTING BEDROOMS_PROPOSED # OF BEDROOMS
A_ Aw c'
(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., 1 Geneva Rd,
B ffWsi:ef,- N`Y °-10-50 9; PhUnc:'(a453)"2 °'o =5 30 .
1. _Cert><fied check or money order for
2. _ 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
4. 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.
5. 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
Early Intervention /Preschool (845) 278 -6014 Fax (845) 278 -6648
r
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
. Associate Commissioner of Health
PUTNAM COUNTY DEPT
I GENEVA ROAD
BREWSTER, NY 10509
To Whom It May Concern:
DEPARTMENT OF HEALTH
I Geneva Road, Brewster, New York .10509
OF HEALTH
Re:
Residence
TAX MAP#
TOWN
According to records maintained by the Town, the above noted dwelling,
ROBERT J. BONDI
County Executive.
IS NOT IN COMPLIANCE WITH TOWN CODE
LEGAL BEDROOM COUNT IS
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
OTHER:
Building Inspector.
Date
CERTIFICATE OF OCCUPANCY Water Supply Section (845) 225-5186 Fax (845) 225-5418
lm
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
SHERLITA AMLER, MD, NIS�FAA,P
° ` "" oirimissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
September 15, 2005
Tim Honors
47 Wenorah Road
Putnam Valley, NY 10579
Dear Mr. Honors:
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
Re:
ROBERT J. BONDI
county zecutive .,,.
Addition — Approval - Honors
No Increase in Number of Bedrooms
47 Wenorah Road
(T) Putnam Valley, T.M. 62.26 -1 -45
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 the Department dated September 15, 2005. The addition is approved with the
following conditions:
1. The total number of bedrooms must remain at three without prior approval.by this
Department.
1 _The-area of the existing se gage d spos4l.$);steziR and its expansion area.must.be..___ -
-
maintained.
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.
T obert ly yo
Morris, PE
Senior Public Health Engineer
RM:cw
cc: Building Inspector, (T) Putnam Valley
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 (845) 278 -6014 Fax (845) 278 -6648
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PUT6M COUNTY DEPARTMENT OF
e HOUSE PLA
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APPROVED FOR BEDROOM COUNT 4)NLY,
MS
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SC,i3A!-:'TAi'6 TO T[iE-PCDOH I
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APPROVAL
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ATE
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AUG -19 -2005 14:44 FROM:PUTNAM COUNTY DEPART 845 -278 -7921 TO:93568021
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