HomeMy WebLinkAbout3793DOCUMENT CONVERSION SERVICES PROVIDED BY
IMAGING & MICROFILM ACCESS, INC.
www.scanyourdocs.com
631- 589 -8100
83.08 -1 -15
BOX 29
03793
♦'
i
`
'I
'
r
' I
03793
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
LORE'1`TA�'MOLINAM R.N., M S.N.? }
Associate Public Health Director
Director of Patient Services
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 Fax (845) 278 - 6648
Preschool (845) 228 - 5912 Fax (845) 228 - 6113
July 23, 2002
Dennis Orlowski
162 Oscawana Lake Rd.
Putnam Valley, NY 10579
Re: Addition - Orlowski, 162 Oscawana Lake
No Increases in Number of Bedrooms
(T)Putnam Valley, TM #83.8 -1 -15
Dear Mr. Orlowski:
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, bearing the approval
stamp from this Department dated July 23, 2002. The addition is approved with the following
conditions:
1. The total number of bedrooms must remain at three without prior approval
by this department.
-2: - .- ...:The arm- ofthe" 6-is -inn sev,'kbC dispoSd sx-z&4 , unu itu enp3risiGa uI°ira; rinlsC L-
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 Vallev.
If you have any questions, please contact me at your convenience.
Very truly yours,
William Hedges
WH:lm Senior Public Health Sanitarian
cc: BI
Q
. ... _lire I
�o
,ak
HAr-46:,ff-12 ROD e SHE�-F
t- v E-up CC)tJHTF-f2i-t
OD 51. ybx 68
- e4y)., U.
e4
Oil
Ql�
-113
10
6vz -
A-5
IH'5UL. zsX68
6LA5 UN G?�
toll�v
Signatur
Z*k
� SEMEN
BA T -N
PLA
1/4 1;� 0
z7'- 011
BRUCE R. FOLEY _
..__..-Ii.OR£T 1'k - MO'L -0-Ir
Associate Public Health Director
Director of Patient Services
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
Environmental Health (845) 278 - 6130 Fax (84S) 278 - 7921
Nursing Services (845) 278 6558 WIC (845) 278 - 6678 Fax (84S) 278 - 6085
Early Intervention (845) 278 - 6014 Preschool (845) 278 -6082 Fax (845) 278 - 6648
�/ o�
ADDITION APPLICATION (RESIDENTIAL ONLY,
STREET A6.? �J1'Cs¢�tJ r¢ Z,9L-,-r / TOWN 14 , w /�r TX MAP# /-s'
\ Cw) 9 /y- S'S'TT —.e o,Vy
NAVIF..1�£y.,rr Oti�Lr/!�/!�,' PHONE 7 PCHD# '-0 2--
MAILI -NIG ADDRESS AO.2
DESCRIPTION OF ADDITION
N % /ell/'l*,�p
N NIBER OF EXISTING BEDROOMS Z PROPOSED # OF BEDROOMS 3
(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.
Ple8e's`ubhiit this "form and fhr 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 4)
*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 _
-S
Feb99
BFhouseguidelines
BRUCE R. FOLEY
Public Health - Dir-ector
LORET'-rA- _WARrI
^' ifsssociate 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
Re: tom. 0
Residence
Tax Map ? 3 . 't' 9 ` 15—
Town fr+-N 4e
Gentlemen:
According to records maintained by the Town, the above noted dwelling
TR V
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:
Building Inspector
BFhouseguidelines
O
. e • ® •
i
Q
•
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
225- (333.0
P OPWA Fc')�`ISF�IA� DiS�t?SAI; SYSTEM REPAIR
^4
CPAM .'S NAME Dennia or1owski PHONE 5h8µ•4254
SITE LOCATION oacawaha. Lake ROAD
MAILING ADDRESS 0 s G a wa n :a t a k a. Road, P a ¢- n :s -m r, A 1 1� �.F� 1, 5 72
PEP-SON INTERVIEWED PCHD Canplaint i
Name & Relationship (i.e, owner,tenant, etc.)
DATE TYPE FACILITY j
PROPOSED INSTALLER s t s g h e n D-; a s t a y L 3 t-n n. PHONE
f:
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 from licensed professional engineer or
registered architect.
n
roposal approved Proposal Disapproved
Inspector's Signature & Title
W
i
I
• oposal approved with the following conditions:
. Procurement of any Town permit, if applicable.
. Submission of as built repair sketch in duplicate shaving:
a. Owner's name.
b. Site Street Name, Town and Tax Map number.
c. Location of installed canponents tied to two fixed points (e.g.,house corners).
d. System description (e.g., 1250 gal. co''hcrete septic tank, three precast.6' diam. x 6' deep
drywells surrounded by one foot + gravel).
e. Installer's name and number.
System repair to be performed in accordance with the above proposal and conditions.
as owner, or reported agent of er agree to the above,-conditions,
r .
TITLEA.�
NATURE .. .. ,,.••
V Abe (FM); Yeucw (Tam BI); Pink (APpLicnnt)
thereof only if said map or copies bear the is
sea] of the surveyor Whose signature appears I
EWM15 le BARDAJRA ORLOWSI<I,
Now or Formerly
;F Co.,
R)ACT CORP.
6.70 030'E.
HE EXISTING CODE OF PRAC-
ADOPTED BY THE NEW YORK
sfor7e ,;50.00,
– Wall
05,00,
8 i 00'
;SIONAL LAND SURVEYORS.
a
vi
conc. S/ab
over Well
MA L AREA = 30,3 79 SO. Fr
Area
250 S. F
qj
Z!h
Now or Formerly
o zt
47
Bruce F &
Rzfrlcla M Fos-ter
E
sz?h
A
(M
'Q,
Q
51. a,
ll
Encl.
Porch
6.70030'
(/0 6.44'/1410)
.co'
—,Grovel
Drive
Q
013
V1
JLL _J.
WORTH
STREET
P.16
Wires 44/
5.70*30'5. t
75.00,
13
Anch
Premises shown hereon being Lots 3,4,5,6
Areo
=1
9,
129 S. F
4i
P10 Lo I 7-,81ock- / and Lots li'pnd 3 -Block Z
as shown on ,nap enfdled " 0scPwono 6orden,
A/. 70'30'N.
/08.79'
near Loke Oscawono said filed in f h
(108.47'A40p)
tij
)ufnam County Clel,',, Offlc,i on March 4
os Mop No. 112.
Al. 7q.- 3 O'W
75.00'
t4
fi
Now or
Formerly Raymond &
Marie DiBe17,edeiio
ERTY
SURVEY .OF PROPERTY
I
�.