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83.12 -2 -6
BOX 30
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03815
Public Health Director
DEPARTMENT OF HEALTH
1 Geneva Road
Brewster, New York 10509
'LtSP .ETT:4;ifl�.1� "~P.F1:,'gv7i.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
March 18, 2002
GabeUNg -Yow
2 South St.
Putnam Valley, NY 10579
Re: Addition- Gabel/Ng -Yow
No Increases in Number of Bedrooms
(T)Putnam Valley, TM #83.12 -2 -6
Dear Gabel/Ng -Yow:
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 March 159 2002. The addition is approved with the following
conditions:
1:..% :*1 The totatnumbero£hedrooms.must remain at three without prior approval: -
'by thig department.
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 yours,
1
Michael Luke
ML:Im Public Health Technician
cc: BI(T)Putnam Valley
a _
BRUCE R. FOI.E_Y
' "Public Health Director
T LORETTA — MOLINARI 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 (835) 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 ONL)I
STREET -d- S 0 VI TH STfE� T TOWN P1477JA-M Vi-Y TX MAP#
NAME GA PAL LN - ON PHONE ° PCHD#
MAILING ADDRESS �- sv wrH s rr-ccr
DESCRIPTION OF ADDITION k, I TG H e N %per .p Q 1 TI o
NUMBER OF EXISTING BEDROOMS :; 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.
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 #)
*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 .
BFhouseguidelines
BRUCE R. FOLEY
Public . Health •... Directtor _ _.
LORETI ;MOLINARfi RN �`MS.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
Re: g L-
Residence
Tax Map 0,12 -Z '40
Town Pt1 r1i1kM V 4 -L-0T
Gentlemen:
According to records maintained by .the Town, the above noted dwelling
IS
is NOT _�...: -..� _... _ __. -.G. � ....� - _. __ .. -- -- •- -
in compliance with Town code and the total number of bedrooms on record is E-.
This information has been obtained from:
CERTIFICATE OF OCCUPANCY:
ASSESSORS RECORD-
OTHER
Building Inspector
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— .27 �. .
PUTNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
PFIUPOSA FOF2 -SAGE DISPOSAL SYSTEM REPAIR
OWNER'S NAME /A/ If 111VVz / � PHONE O ' F30
SITE LOCATION a ,S &v7�4 j / �o�. f TM#
MAILING ADDRESS AlAe A:V2
PERSON INTERVIEWED 0,957 PCHD Canplaint #
Name & Relationship (i.e (2wner t, etc.)
DATE .-L6 -F % TYPE FACILITY
PROPOSED INSTALLER oe L-x� -.Ck C PHONE
REGISTRATION # It
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.
li "Ye.
Proposal approved
Inspector's
Proposal Disapproved
& Title Date
Proposal approved with the followincr 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 components tied to two fixed points (e.g.,house corners).
d. System description (e.g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep
drywells surrounded by one foot + gravel).
e. Installer's name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
I, as owner, or reported agent of owner a ree to
e-*1 1ZV12?,&1t
3IGNATURE
MS: %bite (TOED): Yelkw Mbywn ); Pink (AWli ®nt)
the above conditions. -
TI'T'LE S t o� �Gi DATE —2-- L2