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03309
Y
BRUCE R.. FOLEY
,ka,in Director
viOL'1NAKf 'R N., M.S.N.
Associate Public Health Director
Director, of Patient Services
DEPARTMENT. OF HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (845)278-6130 Fax (845) 278 - 7921
Nursing Services (845) 278 - 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845)278-6014 Preschool (845) 278 -6082 , Fax (845) 278 - 6648
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
February 25, 2003
Re:22 Hickory Lane
Residence
Tax Map 73.5-1-36
Town of P,itnam Valley
Gentlemen:
According to records maintained by the Town, the above noted dwelling
IS
in compliance with Town code and the total number of bedrooms on record is 2
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD: XXXX
OTHER - -- --- -� - - --
BFhouSegutuciilmb
A- I
Existing Floor Plan - 22 Hickory
Lane
MASTER BDRM
13'6 x 13'6
C ) K
CLOSET
67 x 9'1
1P1 x7
32'9
.
BATH
8'2 x 5'9
u
I., Irc
18'7x15'4
LIVING AREA
1046 sq ft
PORCH
8'10 x 6'9
cli
KITCHEN
11'6 x 11'4
O
GD
BEDROOM
9'4 x 13',
CLOSE.
BATH
8'2 x 5'9
u
I., Irc
18'7x15'4
LIVING AREA
1046 sq ft
PORCH
8'10 x 6'9
cli
KITCHEN
11'6 x 11'4
O
GD
BEDROOM
9'4 x 13',
CLOSE.
77-
EO
Existing Floor Plan - 22 Hickory
Lane
32'9
MASTER ER BuRm
13'6 x 13'6
I CLOSET
C O�
CLOS
6�7 . 9",
BATH
49>- -
LIVING
187 x 15'4
M .0
E,
T
1:1
on
11
KITCHEN
11'6xil'4
00
0
BEDROOM
9'4 x 131
0
CLOSET
tl
L_' =w .
Public Health Director
- LORETTA MOLINARI RN., M.S.N.
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (845) 278 - 6130 Fax (845) 278 - 7921
Nursing Services (845) 278 6558 WIC (845) 278 - 6678 Fax (845) 278 - 6085
Early Intervention (845)278-6014 Preschool (845) 278-6082 Fax (845) 278 - 6648
ADDITION APPLICATION (RESIDENTIAL ONLY),
STREET .�:� . TOWN3WMn &e
MAELENG ADDRESS
DESCRIPTION OF ADDITION
\rtJVIBER 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 Road, 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 Ir)
*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
Feb98
Khouseguidelines
.°°:' ' • V' illf�`i i�i'�ivivL'11Eik! 'it:i� ;'`1'v.�:�V� ` �_
Acting Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road, Brewster, New York 10509
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
April 28, 2003
Pauline & James Maloney
22 Hickory Lane
Putnam Valley, NY 10579
Re: Addition-Maloney, 22 Hickory Lane
No Increases in Number of Bedrooms
(T)Putnam Valley, TM #73.5 -1 -39
Dear Mr. & Mrs. Maloney:
County Executive
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 April 28, 2003 The addition is approved with the following conditions:
1. The total number of bedrooms must remain at—without prior approval by this
2. The area of the existing sewage disposal 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 your �\
William Hedges
WH:lm Senior Public Health Sanitarian
cc:BI (T)
•1�9:. sn � �tww9 J1 ,. _.. ..• a�.:Y�c.�; ..+sl!_���laa•w.W'•�.:�j•J"'�•t •ra7�. s•a¢ *J stn S.i'Ea�. w f _ .:q "w.
PROPOSAL TMR SEDGE DISPOSAL SYSTEM[ REPAIR
WRILIM ADDRESS
PERSO24 RMTERVIE WED O W & t_C PCRI
Name & Relationship (i.e, owner,tenant, etc.)
DATE q L TYPE FACILITY
PROPOSED INSTALLER E%C.
REGISTRATION # I r'?,
h (include sketch locating all adjacent wells).
WOO: Repair must be in same location and of same type as original
Different location may require submittal of proposal from licensed
registered architect. ,
Ccgplaint 0
sewage disposal systemo
professional engineer or
. w...._, a�. ..ti._�.�........_._..- ,.c...v,- .,.mow►- ._..... _.r.� -. rv., __,- .....K- .:.�.raa•..- .�...� <r .- ...s�•.�..o.... o•�. - ......- ....___.._
Proposal appro-g� ,\L.
Inspector °s Signature &
Proposal Disapproved
with the followinq conditions:
Date
1. Procurement of any Town permit, if applicable.
20 Submission of as built repair sketch in duplicate showing:
ae Owner Is name.
bo Site Street Name, Town and Tax Reap number.
co Location of installed components tied to two fixed points (eogo,house corners).
do System description (e.g., 1250 gale concrete septic tank, three precast 61 dim. x 61 deep
drywells surrounded by one foot + gravel).
eo Installer's name and number.
3e System repair to be performed in accordance with the above proposal and conditions.
as owner, or reported agent of owner agree
SIG
PAS: VIAte (RAID); YeUcw (Tam HI); Pink (PRli®nt)
to the above conditions.
TITLE P&: o era, DATE L
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