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SHERLITA.AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
ROBERT J. BONDI
County Executive
ROBERT MORRIS, PE
Associate Commissioner of Health Director of Environmental Health
DEPARTMENT OF HEALTH
1 Geneva Road - Brewster, New York 10509
ADDITION APPLICATION RESIDENTIAL ONLY -
STREETS u 1 61-co k Ad. TOWN ,Lnam ; TAX MAP It
PHONE a YS - 7 3 6 - z. o s l PCHD# Y I
tMAILING
DDRESS T
DESCRIPTION OF n(�
� ADDITION I: 7.,, to X 2 FA m
5
NUMBER OF EXISTING BEDROOMS' a 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., 1 Geneva Rd,
Brewster, NY 10509, Phone: (845) 278-6130:
1. Certified check or money order. for $100.00.
'2:.: SP etches of cx st:.ig -Poor plan, (drawn to scale,.all living area rea nchiding base n ints tc:t_?P
shown and dimensioned and use of each room specified). (See Section 3.c of Bulletin
HA -1) .
3. Two sets of proposed floor plans (drawn to scale — with name, street and tax map #)
* Non - professional sketches are acceptable and preferred. (See Section 3.d of Bulletin
HA -1)
14. Copy of survey showing all well and septic locations on the subject property to the best
of your knowledge. Include date of installation known. Contact this office with any
questions.
1 5. .Copy of Certificate of. Occupancy from the Town or Certification from the Building
Department with legal bedroom count of dwelling:
OFFICE USE .
COMMENTS
S.
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
Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention / Preschool (845) 228 -2847 Fax (845) 2251580
a
MEMORY TRANSMISSION REPORT
.'JAIY-�3- ClIIl1•.9115- 1LPN1.
TEL NUMBER 8452787921
NAME. ENVIRONMENTAL HEALTH
FILE NUMBER 367
DATE JAN -13 05:22PM
TO 82784865
DOCUMENT PAGES 001 V
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START TIME JAN -13 05:22PM �y
END TIME JAN -13 05:22PM (�f
SENT PAGES 001
STATUS OK
FILE NUMBER 367 * * * SUCCESSFUL TX NOTICE.***
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SHERLITA AMLER, NID; MS, FAAP ' aJ,� -� ROBERT J. BONDI
Commissioner. of Health * * County Executive
LORETTAMOLINARI, RN, MSN - _ ._ *ROBERT MORRIS, PE
Associate Commissioner of Health Director of Environmental ealth
DEPARTMENT QF.HEALTH
1 Geneva Road Brewster, New York 10509
Town Leval Bedroom Count & Proposed Addition Status
Re: TRFT.AM (Owner's Name)
Tax Map #. 72..19 -132
'Address: 642 Brnnk Road
Town: Putnam Valley
• Year Built:. 1960 .
According to records _maintained by the Town, the above.noted dwelling, '
�s . xx in compliance with Town Code.
Is not in compliance with Town Code.' =
The Legal Bedroom Count is: 2
- :.lids- information has been - obtained- from:
Certificateof'.Occupancy: CO //2005 -223.. (front' entry); C0 #84 -6408 .(addition)
Other:
The plans for the proposed addition are considered:
New Construction
xx Addition to existing house -only
Teardown' and/or re -build allowed under Town Regulations
A11310
"guild rig Inspector.. -.
...Date -
6.
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
'Nursing Home Care. Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention / Preschool (845) 228 -2847 Fax (845) 225. -1580
SHERLITA AMLER, MD, MS, FAAP
Commissioner of Health
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
Bob Ireland
642 Sprout Brook Road
Putnam Valley, NY 10579
Dear Mr. Ireland:
DEPARTMENT OF HEALTH
1 Geneva Road. Brewster, New York 10509
ROBERT J. BONDI
County Executive.
ROBERT MORRIS, PE
Director of Environmental Health
January 14, 2010
Re: Addition — A- 009 -10
642 Sprout Brook Road
(T) Putnam Valley, TM # 72.19 -1 -32
I have received and reviewed the plans for the proposed addition to the above mentioned
residence. Based on the information submitted, the above mentioned addition cannot be
approved for the following reasons:
1. The proposed addition.titled "Family Room" 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 review 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 for three bedrooms.
GDR:kly
Sincerely,
eg
Gene D. Reed
Sr. Environmental Engineering Aide
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
Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580
SHERLITAAMLER, MD, MS, FAAP
V vRof�t�:riscinner of&ah T v
LORETTA MOLINARI, RN, MSN
Associate Commissioner of Health
DEPARTMENT OF HEALTH
1 Geneva Road. Brewster, New York 10509
Mr. Bob Ireland
642 Sprout Brook Road
Putnam Valley, NY 10579 Re:
Dear Mr. Ireland:
ROBERT J. BONDI
County Executive
ROBERT MORRIS, PE
Director of Environmental Health
January 19, 2010
Addition- A- 009 -10
No Increase in Number of Bedrooms
642 Sprout Brook Road
(T) Putnam Valley, T.M. # 72.19 -1 -32
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 January 19, 2010. The addition is approved with the following
conditions:
1. The total number of bedrooms must remain at two without prior approval by this
Department.
2. The area of the existing sewage disposal system and its expansion area must be
maintained.
_... _ .r.... 3. , Ad?- plumbing fixtures must he updated with water. saving,devices, i.e., Tiew,low. flush
toilets, restrictors for shower heads and faucets'etc. a `
4. The approval is for the proposed changes only. This approval does not validate any
construction shown as existing that has not obtained proper approvals
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. 43261.
Sincerely,
Gene D. Reed
Senior Engineering Aide
GDR:kly
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
Nursing Home Care Fax (845) 278 -6085 WIC (845) 278 -6678
Early Intervention / Preschool (845) 228 -2847 Fax (845) 225 -1580
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