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Home My WebLink About3411DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 73.17 -1 -10 BOX 27 7 1111 .,, � le-ilil t wee ' erl 16 Is I �L�� 03411 �i d ; ,HERLITA AMLER, MD, MS, FAAP Commissioner of Health ' - �i LORETTA MOLINARI, RN, MSN Associate Commissioner of Health ROBERT J. BONDI yy _C ..unty Executive. _ .- IFr�'•'O ^O. y/1/.,�_'•� .. .. Ftr`l'4+i�'eT —•bt :• .'II: YI..., .. .. DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 ROBERT MORRIS, PE Director of Environmental Health ADDITION APPLICATION RESIDENTIAL ONLY STREET C7 1A10 L . E TOWN U AX MAP# 3 -0 NAME NOM AS ��W�I� PHONE I �-I- L� j D -�y15 PCHD# ' C?� MAILING , ADDRESS /Z M& IiUUQ D LN• , PIA DESCRIPTION OF ADDITION /. elt WA NUMBER OF EXISTING BEDROOMS 7-' PROPOSED # OF BEDROOMS L _ (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., -: Brewster, NY' 10509, Phone: (845)-.279=6130. Geneva Rd, 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 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 /5.of the property line. Contact this office with any questions. Co pY 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 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 Fax(845)278 -6648 V SHERLITA AMLER, MD, MS, B+AAP Commissioner of Health ... LORETTA MOLINARI, RN, MSN Associate Commissioner of Health Mr. & Mrs. Sawyer 12 Dogwood Lane Putnam Valley, NY 10579 Dear Mr. & Mrs. Sawyer: DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 July 31, 2008 ROBERT .d. BONDI County Executive, ROBERT MORRIS, PE Director of Environmental Health Re: Addition- A- 140 -08 No Increase in Number of Bedrooms 12 Dogwood Lane (T) Putnam Valley, T.M. # 73.17 -1 -10 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 July 31, 2008. 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.. . 3n- All plumbing fixtures ihust be UP wit1 water `saving ^devices; i.e., new 16 t l ush ` toilets, restrictors for shower heads and faucets etc. 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. 2261. Sincerely,�y� A4ell_ J , 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 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 SHERLITA AMLER, MD, MS, FAAP Commissioner of Health LORETTA MOLINARI, RN, MSN Associate Commissioner of Health September 9, 2008 Thomas Sawyer 12 Dogwood Lane Putnam Valley, NY 10579 Dear Mr. Sawyer: DEPARTMENT OF HEALTH I Geneva Road, Brewster, New York 10509 ROBERT J. BONDI County Executive ROBERT MORRIS, PE Director of Environmental Health Re: Addition- A- 140 -08 No Increase in Number of Bedrooms 12 Dogwood Lane (T) Putnam Valley, T.M. # 73.17 -1 -10 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 September 8, 2008. The addition is approved with the following conditions: ®E 1. The total number of bedrooms must remain at two without prior approval by this Department. �-2. -The`area•of _sysfem and"its expansion area must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, iestrictors for shower heads and faucets etc. 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. 2261. 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 WIC (845) 278 -6678 Nursing Home Care Fax (845) 278 -6085 Early Intervention /Preschool(845)278 -6014 Fax(845)278 -6648 SHERLITA.AMLER, MD, ASS, F'AAP .... of Health LORETTA MOLINARI, RN, MISN Associate Commissioner of Health. - - ROBERT J: BONIDI County Executive DEPARTMENT OF HEALTH 1 Geneva Road, Brewster, New York 10509 Town LejZal Bedroom Count Re: E K— (Owner's Name) Tax Map #: % 3. ) 7 -- ) -)C) Address: I 'Z —�� Cr tti1D �7 LEAN Town:-- urr tJ 4 tV\ Year Built: According to records maintained by the Town, the above noted dwelling, is " in compliance with Town Code. is not in compliance with Town Code. The Legal Bedroom Count is: This information has been obtai ed from: Certificate of Occupancy: (CZ S ow blr I p Q ,C V Other: Building 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 (845) 278 -6014 Fax (845) 278 -6648 `_..,:y,.{ .Ji.� us:w -c. .. ^--G q-i .. �.. z '. l- .._r.. _ - . _ _ •- • .-o... y.:�a�niw+rtn.:�c'�pv: <.`•� =s.JZ ,. - -�::._ . "I SUZANNE AND TOM SAWYER 12 DOGWOOD LANE PUTNAM VALLEY, NY 10579 914830.4815 TAX MAP #73.17 -1 -10 EXISTING LAYOUT I— — — — — — — — — — — — — — — — —1 1 I L----------- --- ----------- - - - - -I LIVING AREA 932 sq R Nov 08 05 12:40p Keating Read Estate W 528 0291 P.1 'j fa A (Dat A% IWILIS awe.. let, 4:0 er 2 oAr 'lk .6v w 08/26/2008 10:31 FAX -IFF.vis a D��,� SUZANNE AND TOM SAWYER 12 DOGWOOD LANE PUTNAM VALLEY, NY 10579 914 - 630.4815 TAX MAP #73.17 -1 -10 REVISED LAYOUT X1003/003 ;6�'..- , ;;;:T;, :;,r:,; -, PUTNAM_COUNTY DE kA TMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY BEDROOMS �# Ak, 73, 17 ! -IO ALL SUBSEQUENT REVISION/ALTERATIONS TO THESE HOUSE PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL ATF LIVING AREA 1352 sq Q 30311 DH 30311DH 30311DI 3031DH f O BATH R 10' -0 "x4••11 1 �4 b — Y N BEDRO M w x Or a t4.4 "x174• PUTE ` 304= 3o40DC 15'_4' x 3.9" — \ \ DINING \ \ ft HALL TH 3'4" x 9'.9" 8'4" x 9' 9" 1 6(VING I - 26' -1 "x 16•T' CLOSET P / DECK 10'•1 "x 14'•8" ' \ � \ KITCHEN V -5" x 13'_10• B'OROOM I C,1 / 10' -0" x 11'•6" x r- OFFICE I BEDROOM J f yvJ L_ -� - -1 LIVING AREA 1352 sq Q PUTNAM COUNTY DEPARTMENT OF HEALTH HOUSE PLANS APPROVED FOR BEDROOM COUNT ONLY ALL SUBSEQUENT REVISION /ALTERATIONS TO THESE HOUSE :t PLANS MUST BE SUBMITTED TO THE PCDOH FOR APPROVAL <' SIGNATURE & TITLE DATE SUZANNE AND TOM SAWYER 12 DOGWOOD LANE PUTNAM VALLEY, NY 10579 914 - 630 -4815 TAX MAP #73.17 -1 -10 REVISED LAYOUT F\ — — — — — 1 I I I\ - - - - - - - - J\ / I I I\ I I I I^ I I I I I 1 �!wlu uvlkp�uyu v- - - - - - - - - - - - - - - - - - - - - - - - - - - - LIVING AREA 1286 sq ft OMNER'S NAME SITE LOCATION MAILING ADDRESS irc)1 0 PROPOSAL FUR SEMGE DISPOSAL SYSTEM REPAIR e-S .11, CD PHONE 7W PERSON INTERVIEWED PCIID Complaint # Name & Relationship (i.e, owner,tenant, etc.) DATE C% TYPE FACILITY PROPOSED INSTALLER 0M M PHONE �� 7 REGISTRATION # Pro (include sketch locating all adjacent wells): NOTE: Repair must be in same location and of same type as original sewage disposal system. Different location may require submittal of proposal fran licensed professional engineer or registered architect. Ne. 4.1 k w r A -- lV e" Cc, r-,- cf-C J Proposal s Signature & Ti Proposal Disapproved r000sal amroved with the following conditions: 1. Procurement of any Town permit, if applicable. 2. Submission of as built repair sketch in duplicate showing: a. Owner's name. , b. Site Street Name, Town and Tax Map number. c. Location of installed canponents tied to two fixed points d. System description (e.g., 1250 gal. concrete septic tank, drywel.ls surrounded by one foot + gravel). e. Installer's name and number. (e.g.,house corners). three precast 6' diam. x 6' deep 3. System repair to be performed in accordance with the above proposal and conditions. as owner, or .r agent of er agree to the above conditions. _ SIGNATURE / _ ._ . TITLE C�� zr C:y ✓�`'�. (f DATE , G PIES: %hfte (PCHD) YeUcw (Tam ED[); Pink LbgU,®nt)